News highlights on health security threats and countermeasures curated by Global Biodefense
This week’s selections include the future state of smallpox medical countermeasures; planning for respiratory pathogen pandemics; avian flu in U.S. livestock; and contending with Ebola virus disease sequelae and persistence in research models.
POLICY + GOVERNMENT
CDC Releases Ventilation Guidance for Curbing Indoor Respiratory Virus Spread
As part of its updates on strategies to battle respiratory viruses, the CDC this week detailed steps that people can take to reduce the number of respiratory particles that circulate in indoor air. The ventilation guidance emphasizes the importance of bringing in fresh outdoor air and ensuring that air conditioning and heating systems are operating properly, preferably with filters rated MERV-13 or higher. CIDRAP
Awaiting a Decision on New Research Regulations, Scientists Pen Dueling Articles to Shape ‘Gain-of-Function’ Policies
As they await a decision on policies for potential pandemic pathogen research, dueling camps of scientists have emerged, weighing in through a journal article, responses to the article, and even responses to the responses. Those camps are seeking to undercut or boost the advisory recommendations developed in the wake of the COVID pandemic—and to bolster or diminish the suspicion that a lab accident could have caused it. Bulletin of the Atomic Scientists
Biodefense in the FY25 President’s Budget Request
The FY25 PBR requests $20 billion in mandatory funds to bolster biodefense and public health preparedness and response over the next five years via the Public Health and Social Services Emergency Fund (PHSSEF). $3 billion of this total is budgeted for FY25. Of the $20 billion requested, the Food and Drug Administration (FDA) would receive $670 million, the Centers for Disease Control and Prevention (CDC) $6.1 billion, the National Institutes of Health (NIH) $2.7 billion, and the Administration for Strategic Preparedness and Response (ASPR) $10.54 billion. Council on Strategic Risks
Call for Urgent Agreement on International Deal to Prepare for and Prevent Future Pandemics
A joint letter by 23 former national Presidents, 22 former Prime Ministers, a former UN General Secretary and 3 Nobel Laureates presses for an urgent agreement from international negotiators on a Pandemic Accord, under the Constitution of the WHO, to bolster the world’s collective preparedness and response to future pandemics. The Ninth round of Pandemic Accord negotiations are underway through next week. World Health Organization
Final NIH Budget for 2024 is Essentially Flat
Congress has given the National Institutes of Health (NIH) an essentially flat budget of $47.1 billion, in a final 2024 spending bill. The meager outcome was no surprise: Once the president and Congress agreed to tight spending caps in May 2023, the NIH community started to prepare for little if any new funding. The bill does not include policy provisions championed by the Republican majority in the U.S. House of Representatives that would have curbed diversity efforts at NIH and restricted federal funding for fetal tissue studies and research on gender-affirming care. It drops a proposal to defund two grants to the EcoHealth Alliance, a U.S. nonprofit that in the past worked with virologists in Wuhan, China, on studies some critics suggest could have sparked the COVID-19 pandemic. And it does not include a House-proposed ban on HHS-funded research for risky virus studies known as gain-of-function research. Science
Everyone Wants to Stop the Next Pandemic. But Do They Want to Pay For It?
The Serum Institute of India wants to prepare for the next pandemic — but funding woes may make that difficult. Plus, an Indian model’s controversial approach to HPV vaccine awareness, and USAID’s new $5 billion health contract. Devex
GAO Calls for DOT to Move Ahead on Pandemic Plan
The Department of Transportation (DOT) is expected to release a national aviation pandemic preparedness plan this year and the FAA is paving the way for disease mitigation research, the Government Accountability Office (GAO) reported. However, that plan comes nine years after the GAO first recommended it and four years after the onset of the Covid-19 pandemic. And while the preparedness plan is congressionally mandated, the disease mitigation research is not yet, the watchdog pointed out. AIN Online
MEDICAL COUNTERMEASURES
Smallpox May Be Gone But U.S. Should Better Prepare for its Return, Report Says
Nearly 5 decades after the last documented case, smallpox remains the only human disease that has been officially eradicated. But a new report concludes that the United States can do much to strengthen its ability to respond if the dreaded disease resurfaces, whether naturally, through a lab “leak” of the responsible virus, or from an act of terrorism. Science
MSF Calls for Emergency Stockpile of Ebola Treatments Ten Years After World’s Deadliest Outbreak
As the world marks ten years since the deadliest Ebola virus disease outbreak that killed more than 11,000 people in West Africa, Doctors Without Borders/Médecins Sans Frontières (MSF) is disappointed that while two approved Ebola treatments now exist, they are not readily available via an emergency stockpile for use in places where they would likely be needed in a future outbreak. Médecins Sans Frontières
BIOSECURITY + BIOPREPAREDNESS
Global Health Security Project Launches in Kyrgyzstan
The WHO, FAO, USAID and Kyrgyz Republic are working together to build capacity in tracking and reducing antimicrobial resistance, monitoring zoonotic diseases, strengthening national laboratory systems and disease surveillance, and bolstering health emergency management. Global Biodefense
Recommendations for Strengthening Preparedness Planning in the EU
There remain gaps in the evidence about the effectiveness, costs, and benefits of non-pharmaceutical interventions, which should be addressed given the significant socio-economic consequences of their use as well as their possible important role in the control of future pandemics, particularly during periods where no medical countermeasures are available. This document outlines key strategic and operational considerations. ECDC
Toronto High Containment Facility Granted $10M Modernization Upgrade
As the only high containment facility of its kind in the Greater Toronto Area, the THCF is a unique asset to the life sciences ecosystem in the region, already home to 55 percent of Canada’s pharmaceutical companies. Global Biodefense
Planning for Respiratory Pathogen Pandemics
This module presents an integrated and efficient respiratory pathogen pandemic planning approach covering both novel pathogens and those known to have pandemic potential. It enables coherence in addressing pathogen-agnostic and pathogen-specific elements for better preparedness. World Health Organization
New Groundbreaking Leibniz Lab for Pandemic Preparedness
The Leibniz Lab for Pandemic Preparedness: One Health, One Future in Hamburg, Germany works in four priority areas: the interaction of the environment, animals and humans in relation to the emergence and spread of pathogens, reduction of physical and mental disease burden, efficient pandemic management and improve the resilience of educational systems in pandemic situations. Global Biodefense
SELECT AGENTS + PRIORITY PATHOGENS
The West Africa Ebola Virus Disease Outbreak: 10 Years On
Since the west African EVD outbreak of 2014–16, other EVD outbreaks have been reported from Guinea (1), the DR Congo (8), and Uganda (1). The 2018–20 EVD outbreak in the DR Congo and the COVID-19 pandemic subsequently revealed the inadequacies in the response mechanisms, persisting vulnerabilities, and substantial inequities in the public health emergency response architecture. These inadequacies include an insufficiently skilled health workforce, weak coordination systems, legislative and regulatory mechanism limitations, inequity of access to medical commodities, insufficient finances, and the narrow scope of medical countermeasures. The Lancet Global Health
The Adaptive Immune Response against Bunyavirales
This review highlights the most recent findings regarding T cell and antibody responses to the five Bunyavirales families with known human pathogens (Peribunyaviridae, Phenuiviridae, Hantaviridae, Nairoviridae, and Arenaviridae). Future studies that define and characterize mechanistic correlates of protection against Bunyavirales infections or disease will help inform the development of effective vaccines. Viruses
DR Congo Mpox Outbreak Expands, Becomes Deadlier
An mpox outbreak in the Democratic Republic of the Congo (DRC) that began in 2023 has expanded to 23 of the country’s 26 provinces, including Kinshasa, with children the most affected group. The mpox outbreak involves a different clade of the virus than the one circulating globally. The clade 1 virus in the DRC is known to be more virulent, with a case-fatality rate (CFR) as high as 10%. The DRC is also battling cholera, measles, anthrax, and plague outbreaks alongside an alarming humanitarian crisis. CIDRAP
The Improbable Victory Over Smallpox Holds Lessons for Health Threats in 2024
Smallpox workers understood the need to build trust through partnerships: The WHO’s global smallpox eradication program paired its epidemiologists with community health workers, who included laypeople with training and eager and idealistic medical students. Those local smallpox eradication workers were trusted messengers of the public health program. They leveraged the region’s myriad cultures and traditions to pave the way for people to accept the smallpox campaign and overcome vaccine hesitation. NPR Goats and Soda
Ebola Virus Disease Sequelae and Viral Persistence in Animal Models: Implications for the Future
Existing animal disease models recapitulate acute EVD but are not suitable to investigate the mechanisms of late disease phenomena. Development of an EBOV persistence model to address late disease concerns will aid the development of MCMs against late disease and benefit survivors of future EVD and filovirus outbreaks. The PREVAIL III study is an example of what can be achieved, and we should build upon this data. PLOS Pathogens
Gaps in Forensic Toxicological Analysis: The Veiled Abrin
The clinical symptoms and pathological changes induced by abrin poisoning have not been fully characterized, and there is a lack of standardized methods for identifying biological samples of the toxin. This review provides an overview of the clinical symptoms, pathological changes, metabolic changes, toxicologic mechanisms, and detection methods of abrin poisoning from the perspective of forensic toxicology. Toxicon
AVIAN INFLUENZA
Avian Flu Detected for First Time in US Livestock; Sick Cows in 2 States Test Positive
In an investigation into mysterious illnesses in dairy cows in Texas, Kansas, and New Mexico, tests on unpasteurized milk and nasal swabs have revealed highly pathogenic avian flu in Kansas and Texas. CIDRAP, APHIS
CHEMICAL + RADIOLOGICAL THREATS
Advances in Sprayable Sensors for Nerve Agent Detection
This article comprehensively reviews advancements in nerve agent sensor technologies and detection methods with focus on the emergence of innovative sprayable sensors and provides an overview of advanced chemosensors tailored for sprayable applications. Coordination Chemistry Reviews
Preparedness of German Emergency Departments for CBRN Incidents
Most German hospitals are still not sufficiently prepared to deal with CBRN casualties. One main reason for insufficient preparedness of hospitals for CBRN mass casualties seems to be different responsibilities of authorities in different levels of the administration of the federal government and the federal states in Germany, as well as lack of legislation. While hospital laws in all federal states require a hospital disaster plan, these laws largely do not regulate the content of these plans. Planning and training of staff for managing CBRN casualties is predominantly elective, and both are usually not reviewed by authorities, financed by the public, or covered by health insurance companies. Notfall + Rettungsmedizin
Saliva as an Alternative to Blood for Biodosimetry and Prediction of Radiation-induced Health Effects
This human in vivo study aims to examine radiation-induced gene expression changes in saliva for biodosimetry purposes and to predict radiation-induced disease. Radiation Research
Forensic Biomarkers in a Translational Model of Chlorine Inhalation Injury
The objective of this study was to develop a translational model of chlorine gas-induced acute lung injury in swine to understand toxico-pathophysiology and is suitable for screening potential medical countermeasures, and identify biomarkers useful for forensic analysis. Lung Cellular and Molecular Physiology
Chromo-Fluorogenic Detection of Sarin, Tabun, and Mustard Gas Stimulants
A rhodamine-based chemosensor, BDHA, for the detection of nerve and mustard gas mimicking agents, both in the liquid and vapor phase. Photochemical and Photobiological Sciences
MOF-Enabled Sensor for Rapid Sensing of Low Concentrations of Nerve Agents
Among nerve agents, V-series nerve agents are some of the most toxic, making low-concentration detection critical for the protection of individuals, populations, and strategic resources. This sensor has a limit of detection which is near the nerve agent exposure limit for water samples established by the United States military. ACS Applied Materials and Interfaces
SURVEILLANCE + DETECTION
LFD Sensitivity: Manufacturer Reported Versus Laboratory Evaluation
The purpose of the evaluation is to identify lateral flow devices (LFDs) that display performance characteristics desirable for mass population, community-based testing. Of the 171 LFDs that have completed evaluation, 86 failed at Phase 2; 21 failed at Phase 3 (14 due to low sensitivity and a further 7 failed for other reasons, for example, low specificity or a high rate of kit failure); and 12 failed against variants of concern. For the sample of devices that even qualified for Phase 3 sensitivity testing at Porton Down, there is no correlation between the sensitivity or limit of detection data reported by LFD manufacturers and the that which was observed at Porton Down. “These conclusions support the need for UKHSA to evaluate LFDs at Porton Down to identify high performing devices, rather than relying solely on the manufacturers’ reported performance.” UK Health Security Agency
Next Generation Public Health Emergency Readiness: Standardized Tools and a Threat Agnostic Biosurveillance System
As new biological threats emerge, there is an opportunity to develop threat agnostic biosurveillance capacities via new technologies, tools, and resources – but these must be deployed to and accessible by public health agencies at state, local, tribal, and territorial levels. Health Security
National Road Map to Invest in RNA Science and Biotechnology
A new report from the National Academies of Sciences, Engineering, and Medicine charts a course for developing technologies and infrastructure that would enable the determination of any epitranscriptome of scientific and public interest. The report provides priorities and milestones for a 15-year initiative to advance technology, centralize data resources, expand research and develop standards, and cultivate a skilled workforce in the field. Global Biodefense
Rapid Identification of Bacterial Composition in Wastewater by Combining Reverse Purification Nucleic Acid Extraction and Nanopore Sequencing
In this study, a rapid and portable DNA extraction protocol was developed and verified to identify the microbial wastewater composition by nanopore sequencing. The study compared different pretreatment and buffer options combined with the reverse purification principle. Extraction efficacy was assessed using Staphylococcus aureus and Escherichia coli spiked wastewater and crude samples from different collection points at the treatment plant. ACS ES&T Water
Portable Smartphone-Based Molecular Test for Rapid Detection of Leishmania spp.
This study aimed to test the accuracy of a portable minoo device, a small battery-driven, multi-use fluorimeter operating with isothermal technology for molecular diagnosis of visceral leishmaniasis and post kala-azar dermal leishmaniasis. Infection
Funding Crunch Threatens a Key Virus-Fighting Tool: Tracking America’s Poop
Wastewater testing — supercharged by the creation of a national surveillance system in 2020 — has been one of the more reliable metrics for tracking COVID-19 spread since other data, like daily case counts and testing, became much more scarce last year. It will take more funding and more government buy-in for wastewater surveillance to become a permanent fixture of American public health, but the U.S. risks repeating the same mistakes that hampered the initial COVID response. Axios
INFECTIOUS DISEASES
Yellow Fever in the Americas
Three countries in the Americas have reported a total of seven yellow fever cases this year. Of the seven cases, four were fatal. Brazil additionally reported detections in nonhuman primates. The risk in the Americas remains high due to impacts from the COVID-19 pandemic leading to gaps in vaccine coverage. CIDRAP, PAHO
Following Measles Outbreaks, Officials Grow Wary of Renewed Threat
The Centers for Disease Control and Prevention has recorded more cases this year than the 58 tallied in all of 2023. The number of cases is likely to keep rising because of a sharp spike in measles worldwide, along with spring travel. Measles is among the most contagious of diseases; each infected person can spread the virus to as many as 18 others. The virus is airborne and can stay aloft up to two hours after an infected person has left the room. New York Times
The Deadliest Infectious Disease Isn’t a Science Problem. It’s a Money Problem.
Tuberculosis is generally curable. And it’s the world’s deadliest infectious disease. In 2022, TB killed 1.3 million people— more than Covid-19 or malaria or HIV. Each week, 25,000 people die of TB, a bacterial infection that primarily attacks the lungs. The best standard of care requires between four and nine months of antibiotics taken daily. Of the 10 million people who will become sick with tuberculosis this year, between 3 million and 4 million will go undiagnosed, often dying before they can get an accurate test. Washington Post
Whooping Cough: Over 3000 Cases Reported In Czechia So Far This Year
The Czech Republic is experiencing a serious outbreak of pertussis, also known as whooping cough, with over 3084 cases reported so far this year – a number not seen since 1963. As cases continued to rise, political dysfunction has muddled guidance. BBC
COVID-19 PANDEMIC
FDA Grants EUA to Monoclonal Antibody for PrEP of COVID-19 in Immunocompromised
The FDA announced it has granted an emergency use authorization to monoclonoal antibody pemivibart (Pemgarda) for the pre-exposure prophylaxis (PrEP) of COVID-19 for both adults and adolescents at least 12 years of age and immunocompromised. The mAB is the first to receive an EUA based on a rapid immunobridging trial design that is expected to be repeatable to help address the need to mitigate ongoing viral evolution. Contagion Live
SPECIAL INTEREST
CROI 2024 Denver: Really Rapid Review
It’s the first time CROI has been in Denver since 2006 and, while no one presented a viable strategy for HIV cure or an effective HIV vaccine, we saw plenty of interesting studies. Here’s a sampling, roughly ordered by treatment, complications, and prevention. NEJM Journal Watch
The Women of JPL CBRND Enabling Biotechnologies
In honor of Women’s History Month, members of the Joint Project Lead for Chemical, Biological, Radiological and Nuclear Defense Enabling Biotechnologies (JPL CBRND EB) share their thoughts on their mission, and the role models that serve as a source of inspiration to each of them. Global Biodefense
CEPI Calls For Experts to Join Its Scientific Advisory Committee
CEPI’s call for new individuals to join its Scientific Advisory Committee, or SAC —an external expert group providing guidance and recommendations to CEPI on R&D programs and broader outbreak response efforts—is now open through 9 April 2024. CEPI
ALSO READING
The USGS One Health Approach to Infectious Diseases of Wildlife and Environmental Change. USGS
Recent Advances in the Epidemiology of Pathogenic Agents. Pathogens
Isolation of Batborne Neglected Zoonotic Agent Issyk-Kul Virus, Italy. Emerging Infectious Diseases
UK Health Security Agency Joint Modelling Team papers. UKHSA
A Legal Mapping of 48 WHO Member States’ Inclusion of PHEIC, Pandemic, and Health Emergency Terminology Within National Emergency Legislation. The Lancet
Screening Peptide Drug Candidates to Neutralize Whole Viral Agents. ACS Pharmacology and Translational Science
Ecological Countermeasure to Prevent Pathogen Spillover and Subsequent Pandemics. Nature Communications