News highlights on health security threats and countermeasures curated by Global Biodefense
This week’s selections include a promising treatment for Ebola Sudan, ASPR’s budget assessment for medical countermeasures for the next few years, and the path to enable threat-agnostic signatures for biodefense.
POLICY + GOVERNMENT
ASPR Releases Public Health Emergency Medical Countermeasure Enterprise Multiyear Budget Assessment for FY 2023-2027
The PHMCE MYB assessment forecasts to Congress and external stakeholders the funding required to fully prepare the country for a range of chemical, biological, radiological, and nuclear threats, without regard to the competing priorities considered in the President’s Budget. This MYB estimated overall funding needs of $79.5 billion over the five-year period, an increase of $15.5 billion over the 2022-2026 report. The MYB is not a budget request and does not replace funding levels requested in the President’s Budget or accompanying documents. HHS ASPR
Ready or Not 2024: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism
The 2024 report, it’s 21st annual edition, found that while emergency preparedness has improved in some areas, policymakers not heeding the lessons of past emergencies, funding cuts, and health misinformation are putting decades of progress in public health preparedness at risk. Key findings include too few people being vaccinated against seasonal flu; only a quarter of acute care hospitals earn top-quality patient safety grades (things like HAIs, ICU capacity, error prevention); and only 55% of U.S. workers access paid time off, an important readiness measure because workers who go to work sick risk spreading infections in the workforce and community. Trust for America’s Health
A Treaty to Prepare the World for the Next Pandemic Hangs in the Balance
After eight rounds of often contentious negotiations in Geneva, the WHO Pandemic Agreement is nearing the finish line. On 7 March, WHO sent member states a draft text that will be subject to one more round of negotiations starting on 18 March. In late May, the final draft heads to the World Health Assembly, the annual gathering of WHO member states, for approval. Science, Devex
Gov. Murphy Admits COVID Mistakes, Vows to Improve N.J. Pandemic Response After Critical Report
Gov. Phil Murphy said he will spend the rest of his second term implementing a long list of recommendations that will improve New Jersey’s response to the next pandemic, vowing “to learn from our mistakes.” This was the first public interview the governor has given since a team of lawyers and consultants released a 910-page report examining the state’s response to the COVID-19. NJ.com
AMR Appropriations in the US FY2025 Budget
If you follow US politics, you will know that the USG (US Government) is beginning its appropriations process for FY2025 (Federal Year 2025). In preparation, a letter calling for Antimicrobial Resistance (AMR)-related funding has been drafted by the Infectious Diseases Society of America (IDSA), AdvaMedDx, American Society for Microbiology (ASM), Association for Professionals in Infection Control and Epidemiology (APIC), BIO, Food Animal Concerns Trust, and the Society for Healthcare Epidemiology of America (SHEA). Sign-on to the letter here. AMR Solutions
MEDICAL COUNTERMEASURES
Gilead Antiviral Drug Shows Promise as a Treatment for Ebola Sudan
A new NHP study suggests the antiviral drug obeldesivir may be effective in curing Ebola Sudan infections, for which there are currently no approved vaccines or treatments. Obeldesivir is given in pill form — in this study in a regimen of one pill daily for 10 days. If the drug is shown to be effective in people and is approved, it would be the first treatment for any type of Ebola that is given orally. STAT, Science
Technical Advisory Group on Therapeutics Prioritization Call for Experts
The WHO is seeking experts to serve as members of one of the Technical Advisory Group (TAG) on Therapeutics Prioritization. The TAG is an independent group of experts convened to provide guidance on research to select medicines to included in clinical trials to evaluate their efficacy against diseases of epidemic and pandemic threat, for which current tools for prevention are inadequate or inexistent. Register interest by 2 April. World Health Organization
Expanding Delivery and Increasing Uptake of Medical Countermeasures Through Public–Private Partnerships
Proceedings from a series of virtual workshops hosted by the NASEM Forum on Medical and Public Health Preparedness for Disasters and Emergencies to examine lessons and discuss future opportunities for public–private partnerships to facilitate the distribution, dispensing, acceptance, and uptake of medical countermeasures in a public health emergency. National Academies
Recent Advances in the Treatment of Ebola Disease
Several therapeutic drugs, including GP inhibitors and PIs, are currently being investigated in preclinical trials and demonstrating promising results. Some of the GP inhibitor options, identified through computational analysis, are FDA-approved drugs like clomiphene that has demonstrated efficacy in cell cultures only. Recently, host factors involved in viral processes and immune response have garnered attention as therapy targets. Amiodarone, shown to inhibit viral membrane fusion in vitro, was tested in Sierra Leone but later withdrawn due to inconclusive effects in animal models. Another potential interaction of interest is the between ebolaviruses and the Niemann–Pick C1 receptor (NPC-1), with multiple molecules exhibiting adequate anti-Ebola activity in vitro. PLOS Pathogens
Large-Scale Production of EVs from Mesenchymal Stromal Cells for Treatment of Acute Radiation Syndrome
Given the complexity of generating cellular therapies and the potential risks of using allogeneic products, development of an “off-the-shelf” cell-free alternative like extracellular vesicles (EVs) may have utility in conditions like H-ARS that require rapid deployment of available therapeutics. The purpose of this study was to determine the feasibility of producing MSC-derived EVs at large scale using a bioreactor and assess critical quality control attributes. Stem Cell Research and Therapy
BIOSECURITY + BIOPREPAREDNESS
Tool for Assessing Pandemic Origins: New Details from NTI
A new white paper was published this week on the proposed Joint Assessment Mechanism (JAM), a tool for discerning the source of high-consequence biological outbreaks of unknown origin. The paper provides an in-depth argument for establishing the JAM to fill the critical gap among existing UN mechanisms and entities. The paper further suggests that the JAM should be based within the Office of the UN Secretary General—serving as an interface between the WHO, the UN Secretary-General’s Mechanism, and other key stakeholders. NTI
Reply to Lipsitch et al., “Public Role in Research Oversight”
Lipsitch et al. assert that it is feasible to prepare for the next pandemic through research that avoids the use of infectious pathogens. However, theoretical assumptions and contrived experimental systems have serious limitations and often do not support accurate the prediction of risk. A common example is the use of pseudotyped viruses, which can be useful for examining viral entry but may be misleading due to differences in the 3D arrangement and density of spikes. Pseudotyped viruses cannot provide information about post-entry stages of the viral life cycle or complex virus-host interactions required for transmission and pathogenesis. Furthermore, prototype viruses, such as murine coronaviruses, are valuable for studying basic virus biology but inadequate for understanding the transmission, virulence, and pandemic potential of emerging viruses. Deciphering these nuances is where virology expertise is essential. Journal of Virology
Reply to Ebright et al., “Implementing Governmental Oversight of Enhanced Potential Pandemic Pathogen Research”
Measles and cytomegalovirus, while important public health concerns are not potential pandemic pathogens. However, both possess traits that fit the NSABB’s proposed PPP definition: they are moderately or highly transmissible and/or virulent and potentially pose a severe threat to public health, health system capacity, or national security in unvaccinated populations. The NSABB proposed oversight therefore captures important research that Ebright et al. also do not consider to be of concern, exemplifying the over-broadness of the NSABB recommendations. This proposed oversight would harm US competitiveness in multiple ways, most immediately in the development of antiviral drugs and vaccines. Ebright et al. proclaim it is “indefensible” to work with international institutions that do not meet US standards. However, it is imperative to US preparedness to track infectious diseases across borders, even in places where biosafety standards should be higher. We should be working to raise biosafety standards everywhere, especially in PPP research. Journal of Virology
The Biosafety Incident Response Competence Scale for Clinical Nursing Staff
Nurses with good biosafety event response capabilities can efficiently treat infected patients, contain the spread of biosafety infections, and to the largest extent minimize the disease severity. Their response competence is not only related to biosecurity threat warning, but also related to the effectiveness of the biosafety infection treatment. This study explains the steps taken to develop a new tool to measure these competence for clinical nurses. BMC Nursing
Proposed Changes to Approval Tests and Standards for Combination Unit Respirators
The Department of Health and Human Service (HHS) proposes to amend regulatory requirements that would be used by the Centers for Disease Control and Prevention’s (CDC) National Institute for Occupational Safety and Health (NIOSH) to test and approve combination unit respirators. This rulemaking would establish this new class of respiratory protective device, combination unit respirators (CURs). Public comments are due 14 May. Federal Register
WHO Updates Laboratory Biosafety Guidance Related to SARS-CoV-2
Non-propagative diagnostic laboratory work (for example, sequencing, nucleic acid amplification test [NAAT]) should be informed by a risk assessment and conducted at a facility using procedures and effective risk control measures corresponding to Biosafety Level 2 (BSL-2). World Health Organization
SELECT AGENTS + PRIORITY PATHOGENS
More than 600 Dead in Spreading DR Congo Mpox Outbreak
The country’s health ministry and the DRC office of the World Health Organization provided updated numbers this week on the ongoing Clade 1 mpox outbreak, noting 14,626 suspected cases were reported since the start of 2023, with 654 deaths, for a case-fatality rate of 4.5%. Last week, scientists reported that heterosexual transmission is helping fuel the DRC outbreak. CIDRAP
Untold Lassa Fever Story: A Physician’s Lived Experience
Obstetricians and gynaecologists are disproportionately affected by hospital-acquired Lassa infections due to the disease’s resemblance to obstetric emergencies. Sepsis, hypertensive disorders of pregnancy, and obstetric haemorrhages closely mimic Lassa fever symptoms during pregnancy, leading to potential misdiagnoses and delayed treatment. Indeed, in the endemic community, Lassa fever has been described as a hidden cause of maternal mortality. The Lancet Infectious Diseases
Analysis of the Dynamics of Anthrax Epidemic Model with Delay
The aim of study to investigate the nonlinear dynamics of an anthrax model with delay effects, which incorporates the delay mechanism of its incubation period. This involves studying the various stages of anthrax infection, transmission, and progression in a population over time. Discover Applied Sciences
Q Fever Case Spike in Queensland Drives Renewed Push for More Accessible Vaccine
Q fever cases have spiked in Queensland, with 89 reported infections across the state so far this year, an increase of almost 90 per cent on the same time in 2023. The surge of infections has prompted calls for a better vaccine with improved accessibility. Q-Vax is the only vaccination for Q fever in the world and is only available in Australia. It is recommended for people aged 15 years and older whose work involves contact with high-risk animals such as abattoir employees, shearers, vets, and animal refuge workers. But Dr Donohue said he would like to see a wider take up of the vaccine. ABC News Australia
Current Vaccine Strategies and Novel Approaches to Combatting Francisella Infection
Despite decades of research, there are no approved vaccines against F. tularensis in the United States. Traditional vaccination strategies, such as live-attenuated or subunit vaccines, are not favorable due to inadequate protection or safety concerns. Because of this, novel vaccination strategies are needed to combat tularemia. Here we discuss the current state of and challenges to the tularemia vaccine field and suggest novel vaccine approaches going forward. Vaccine
AVIAN INFLUENZA
Wildlife Under Threat as Avian Influenza Reaches Antarctica
The ongoing spread of high pathogenicity avian influenza (HPAI) has now reached an unprecedented milestone with reports of its recent detection on Antarctica’s mainland. HPAI has ushered in a “new normal” whereby HPAI is moving from wild birds to wild mammals with impacts beyond anything previously seen. Estimates vary, but at the latest count, there have been 485 species from over 25 avian orders affected and 37 new mammal species infected since 2021. WOAH’s Working Group on Wildlife has produced new guidelines on the emergency vaccination of wild birds of high conservation importance against HPAI and the management of HPAI in marine mammals. World Organisation for Animal Health
CHEMICAL + RADIOLOGICAL THREATS
Effect of Types of Two Different Full-Face Masks Used in CBRN Events on Endotracheal Intubation Time
Healthcare personnel may have to intervene with the injured using personal protective equipment depending on the environmental conditions. In injuries occurring in CBRN events, healthcare personnel may have to intervene in the injured using personal protective equipment. The equipment used may lead to limitations, especially in cases requiring advanced airway intervention such as intubation. In this study, the effects of personal protective equipment on the intubation times of healthcare personnel were investigated. Heliyon
Senate Passes Bill to Expand Compensation for Radiation Victims. Will the House Agree?
The Senate approved a significant bill to broaden and prolong the Radiation Exposure Compensation Act with bipartisan support. However, the bill’s prospects in the House of Representatives remains unclear. First passed in 1990, the Radiation Exposure Compensation Act (RECA) provides lifesaving benefits to Americans who, since 1945, have suffered directly from radiation exposure-related illnesses. Bulletin of the Atomic Scientists
Long-Term, Non-Invasive FTIR Detection of Low-Dose Ionizing Radiation Exposure
Biological indicators of human exposure to ionizing radiation are pertinent to screen large numbers of people potentially exposed to radiation, e.g. after a nuclear accident or a radiological attack. A main challenge of risk assessment for persons potentially exposed to ionizing radiation is in measuring the biochemical changes non-invasively and in real-time. Here researchers chose skin as the target given it is readily accessible in a way that blood and internal organs are not. Scientific Reports
SURVEILLANCE + DETECTION
Computational and Systems Biology Advances to Enable Bioagent Agnostic Signatures
The biodefense community should shift from an identification-based approach to a characterization-based one by developing bioagent agnostic signatures (BASs), defined as measurable suites of biomarkers that accurately and reproducibly assess the impacts of infection or intoxication without a priori knowledge of an agent. Retooling the US biodefense posture from a list-based approach to a dual list-based and BAS-based approach will require policy changes, technological improvements, and improved data analytics. Health Security
Feasibility of Wastewater-Based Detection of Emergent Pandemics Through a Global Network of Airports
There has been limited effort paid to quantitatively assessing the feasibility of detecting the presence of SARS-CoV-2, or some other emerging respiratory pathogen, in wastewater generated by passengers on board, despite the ample data available for analysis. To fill this gap, we constructed a probability model to retrospectively estimate the likelihoods of discerning the virus from wastewater of inbound flights at a diverse set of airports, utilizing epidemiological information of SARS-CoV-2, air travel data, and considering various sampling strategiesss. PLOS Global Public Health
Benchmarking CRISPR-BP34 for Point-of-Care Melioidosis Detection
Clinical specimens from patients with suspected melioidosis are typically screened for the presence of B. pseudomallei using microbial culture, which has been the gold-standard diagnostic method for the past three decades. This method is imperfect, with a specificity of 100% but a sensitivity of 60% and delays in time to result. Improved performance through detection of B. pseudomallei DNA from direct clinical specimens could improve melioidosis diagnosis. The Lancet Microbe
Diagnostic Evaluation of PanBio and Standard Q Rapid Antigen Tests for SARS-CoV-2
This retrospective cross-sectional study was conducted among 1171 suspected COVID-19 patients at a provincial hospital in Nepal. Each participant provided two nasopharyngeal swabs, one for RDT and the other for rRT-PCR, spanning a total duration of four months. International Journal of Surgery: Global Health
INFECTIOUS DISEASES
How the APHL/CDC VPD Reference Centers are Working to Identify Measles Outbreaks
In 2013, APHL, in partnership with CDC, established four Vaccine Preventable Diseases (VPD) Reference Centers to help reduce the diagnostic load of state laboratories and assist with the pathogen typing that’s necessary to detect the origin and spread of disease outbreaks. These four centers—located in California, New York, Wisconsin and Minnesota—perform molecular testing for the viruses that cause measles, mumps, rubella (German measles), chickenpox, enterovirus (which can cause diseases like polio and hepatitis A) and MERS-CoV (Middle East respiratory syndrome-related coronavirus). The Wisconsin and Minnesota centers also perform bacterial pathogen testing. APHL Blog
No Parent Who Has Seen the Children I’ve Treated for Measles Would Refuse a Vaccine
“Where I live, in one of the poorest places on earth, measles kills thousands of children a year. It’s a grim lesson about a disease that should have been eradicated years ago. And it’s a grave warning against assuming “it can’t happen here” in more fortunate countries like the U.S., where the disease is making a comeback as parents fail to take the disease seriously. For years, U.S. pediatricians have gone their entire careers without seeing a case of measles, much less a death. Now, I fear, that may change.” STAT
COVID-19 PANDEMIC
Long-Term Outcomes Following Hospital Admission for COVID-19 Versus Seasonal Influenza: A Cohort Study
Although rates of death and adverse health outcomes following hospital admission for either seasonal influenza or COVID-19 are high, this comparative analysis shows that hospital admission for COVID-19 was associated with higher long-term risks of death and adverse health outcomes in nearly every organ system (except for the pulmonary system) and significant cumulative excess disability-adjusted life-years (DALYs) than hospital admission for seasonal influenza. The substantial cumulative burden of health loss in both groups calls for greater prevention of hospital admission for these two viruses and for greater attention to the care needs of people with long-term health effects due to either seasonal influenza or SARS-CoV-2 infection. The Lancet Infectious Diseases
The Importance of T-Cells: Antibody-Independent Protection Against Heterologous SARS-CoV-2 Challenge
This study invites us to re-evaluate and refine the prevailing immunological paradigm concerning SARS-CoV-2. Current vaccine strategies overwhelmingly focus on generating potent neutralizing antibodies. Given the transient lifespan of such antibodies and the burgeoning threat of evasion by viral variants, the persistent efficacy of T cell responses challenges the notion of periodic vaccine updates and regular boosting. The findings presented herein suggest that T cells can furnish robust immunity against heterologous SARS-CoV-2 challenges, even in the absence of humoral responses. Nature Immunology
SARS-CoV-2 Shedding and Evolution in Immunocompromised Patients
Although numerous case reports of SARS-CoV-2 infection in people who are immunocompromised have documented substantial mutation accumulation in spike that mirrors mutational profiles in VOC, this analysis showed comparatively restricted SARS-CoV-2 evolution over a wide spectrum of immunocompromising conditions. Duration of infection and evolution of SARS-CoV-2 were observed more frequently in patients with B-cell malignancy and B-cell depletion than in patients with other forms of immunocompromise. The Lancet Microbe
CDC Continues to Receive Reports of MIS-C in Kids Following COVID Infections
Cases of multisystem inflammatory syndrome (MIS-C), a rare but serious COVID-19 complication in children, have decreased from the earlier pandemic months but continue to be reported. Among 117 patients with MIS-C in 2023, approximately one half required intensive care unit–level care. More than 80% (92 of 112) of MIS-C cases were in vaccine-eligible but unvaccinated children, and among the 20 vaccinated children, 60% likely had waned immunity at the time of MIS-C illness. CIDRAP, MMWR
Bivalent (Omicron BA.5/Ancestral) Recombinant Spike Protein Vaccine: A Promising Booster
The robust neutralising antibody response against Omicron BA.5 and XBB.1.5 after two doses of the bivalent subunit vaccine showed that this vaccine can be used as an effective booster against Omicron variants. Heterologous boosting in COVID-19 mRNA vaccine participants was highly effective, and likely to be effective in those who were previously primed with an inactivated or an adenovirus vectored COVID-19 vaccines. This bivalent subunit vaccine will provide a useful option as a booster vaccine for older people and high-risk individuals, in particular, those who cannot or do not want mRNA variant vaccines. The Lancet Infectious Diseases
SPECIAL INTEREST
Movie Special: Outbreak and Contagion with Saskia Popescu
Have a listen to Brett Edwards’ first ever movie review special, in which Dr. Saskia Popescu joins to review the classics Contagion (2011) and Outbreak (1995). Poisons and Pestilence
Brown University CS Student Sabrina Chwalek Worked to Reduce Nuclear and Biological Threats in Her Recent Internship
Read about Sabrina’s experience interning with NTI’s Global Biological Policy and Programs team, which focuses on countering global catastrophic biological risks, strengthening pandemic preparedness, and building accountability for global health security progress. Brown University
CSR Fellowship for Ending Bioweapons
In this one-year Fellowship, participants will work with leading experts committed to biological threat reduction and biosecurity, including former government officials who helped dismantle Cold War-era biological weapons capabilities, advance international biological cooperation, and drive policy progress. Fellows will gain deep knowledge of what it takes to address biological risks and a strengthened network among biosecurity experts. Applications are due 8 April. Council on Strategic Risks
Next Generation for Biosecurity Competition Open for Applications
The competition invites innovative and creative papers focused on how investments in biosecurity can contribute to a more equitable society and reduce biological risks. Applicants must be currently enrolled in an academic institution or have less than five years of professional experience. Applications are due 2 June. NTI
Addressing the Challenges Posed by Chemical and Biological Weapons
SIPRI and the European Union Non-Proliferation and Disarmament Consortium (EUNPDC) invite graduate and postgraduate students of the technical or natural science disciplines to apply for an intensive online introductory course on chemical and biological weapons—their proliferation, the efforts to eliminate them, the various mechanisms used to control their spread—and endeavours underway to reduce the risk of chemical or biological agents in terrorist attacks. The course will take place online, during four half-days on 28–31 May 2024. SIPRI
Internship with the Office of the Pandemic Preparedness and Response Policy
OPPR drives and coordinates federal science and technology efforts related to pandemic preparedness. The Fall 2024 term begins on 16 September 2024 and ends on 20 December 2024. Interns will receive a stipend for participation in the program. Internships will be hosted in person on the White House campus, located in Washington, D.C. Applications due 12 April. The White House
Apply to the ISID Emerging Leaders Program 2024
The ISID Emerging Leaders Program was developed to recognize excellence in the field of infectious diseases at an early career level, to facilitate capacity building and succession planning and to give select, promising early career investigators and physicians the opportunity to become familiar with the Society’s work, engage in ISID’s activities, showcase their work and network with colleagues around the world. Emerging Leaders will serve a four-year term. Applications are due 24 May. International Society for Infectious Diseases
ALSO READING
Is eradication of influenza B viruses possible? The Lancet Infectious Diseases
Viral emerging and re-emerging diseases: basic understanding and future intervention strategies. Frontiers in Microbiology
Two West Texas infants in the same neighborhood diagnosed with rare botulism. Texas Tribune
Building pyramids against the evolutionary emergence of pathogens. Proceedings of the Royal Society B
Where public health stands 4 years after the COVID-19 pandemic began. NPR
Digital Surface-Enhanced Raman Spectroscopy–Lateral Flow Test Dipstick. Environmental Science & Technology
Shoring up the foundations of pathogen surveillance. The Lancet Microbe
Management of infodemics in outbreaks or health crises: a systematic review. Frontiers in Public Health
Protective potential of outer membrane vesicles derived from a virulent strain of Francisella tularensis. Frontiers in Microbiology
The health and care workforce in the Pandemic Agreement: championing equity and protecting collective capacity for future pandemics. The Lancet Global Health