News highlights on health security threats and countermeasures curated by Global Biodefense
This week’s selections include new terminology for pathogens spread through the air, risks posed by the ongoing Clade I mpox outbreak, more dairy herds with H5N1, and testing skin decon kits against novichok agents.
POLICY + GOVERNMENT
Global Health Groups Propose New Terminology for Pathogens That Spread Through the Air
Well into the COVID-19 pandemic, WHO and the CDC were reluctant to use terms like “airborne,” “airborne transmission,” and “aerosol transmission” to describe the spread of the virus through the air, while other experts used various definitions to describe the phenomenon, sowing confusion about how the disease was circulating. A new report proposes new umbrella terminology for pathogens that transmit “through the air,” which include not only SARS-CoV-2, but also influenza, measles, MERS-CoV, SARS, and tuberculosis. CIDRAP, WHO
Biden Administration Announces Global Health Security Partnership with 50 Countries as Pandemic Accord Flails
The announcement about the strategy comes as countries have struggled to meet a worldwide accord on responses to future pandemics. Four years after the coronavirus pandemic, the prospects of a pandemic treaty signed by all 194 of the World Health Organization’s members are flailing. AP, White House
A New Global Health Security Strategy
Transcript from a 16 April CSIS event featuring Dr. Stephanie Psaki, who is the deputy senior director for global health security and biodefense at the National Security Council, and the deputy assistant to the president, and the inaugural U.S. coordinator for global health security. CSIS
The ASAP Framework: A New Tool for Regulatory Agencies to Facilitate Adoption of Pandemic Approaches
In recognition of the need for a structured way to design, implement, and assess the sustainable retention of pandemic practices by regulatory agencies, the authors sought to identify factors that promote or limit the adoption of regulatory approaches. The ASAP framework is an organizing tool to help guide policy and implementation planning for regulators. Health Security
Executive Orders on COVID-19 Pandemic Rescinded
In a new EO, a number of pandemic-related provisions were rescinded or revoked. The positions of COVID-19 Response Coordinator and Deputy Coordinator of the COVID-19 Response were terminated. EOs in place since 2020 governing pandemic supply hoarding, mask wearing, and COVID-19 travel safety were also revoked. Federal Register
MEDICAL COUNTERMEASURES
A Resistance-Evading Antibiotic for Treating Anthrax
Ciprofloxacin, levofloxacin, penicillin and doxycycline are currently approved for antimicrobial prophylaxis and treatment of B. anthracis infection. Additional antibiotics are being introduced to treat anthrax as well. For example, BARDA is stockpiling omadacycline, an antibiotic from the tetracycline class, to treat anthrax in case of a bioterror attack. Here researchers postulated that teixobactin, an antibiotic with no detectable resistance, is uniquely suited to address the challenge of weaponized anthrax and conducted a study in a rabbit model. Europe PMC
Design and Characterization of Protective Pan-Ebolavirus and Pan-Filovirus Bispecific Antibodies
Here researchers engineered “bispecific” antibodies in which activities of two different mAbs were combined into one. These bispecific antibodies had broad activity, in one case providing protection against lethal challenge by two distant clades of filoviruses (EBOV and MARV). The bispecific antibodies were also less susceptible to resistance mutations. PLOS Pathogens
BIOSECURITY + BIOPREPAREDNESS
Seven Opportunities for Effective Biosafety and Biosecurity Governance
Biological incident reporting is fragmented and only required in certain circumstances, such as needlesticks in a workplace, potential exposures to recombinant or synthetic nucleic acids, or incidents involving a biological select agent or toxin. By exploring the reporting mechanisms of other industries, such as healthcare, aviation, and nuclear energy, we believe it is possible to protect individuals and institutions from reputational and legal harms while also providing a real-time system to collect and report biological incident data. Health Security
We Need to be Ready for Biotech’s ChatGPT Moment
Like the digital revolution, the biotech revolution stands to transform America’s economy as we know it—and it’s coming faster than we expect, turbocharged by AI. It’s crucial we secure a reliable supply chain domestically and internationally that covers everything from raw material extraction to data storage, establish appropriate guardrails, and invest in talent development. Time
SELECT AGENTS + PRIORITY PATHOGENS
Rapid Risk Assessment: Risk Posed to the United States by Clade I Mpox Outbreak in the DRC
There is an ongoing outbreak of mpox in DRC caused by the clade I mpox virus, which is distinct from the clade IIb mpox virus that caused the 2022 global outbreak. As of March 29, DRC reported 4,488 confirmed or suspected cases of mpox in 2024. In previous outbreaks, clade I has caused more severe disease and been more transmissible than clade II within close-contact settings, typically in a household. Although clade I mpox is endemic in DRC, in 2023, health authorities reported a higher number of cases and deaths across a wider geographic area that in some provinces affected atypical demographic groups. Approximately 70% of suspected mpox cases in DRC in 2024 were in children under age 15, similar to historical observations. However, adults were disproportionately affected in South Kivu province, where sexual transmission was predominant.
CDC assessed the overall risk to the United States posed by the clade I mpox outbreak in the DRC for two populations. The risk to the general population is assessed as VERY LOW. The risk to gay, bisexual, and other men who have sex with men (MSM) who have more than one sexual partner and people who have sex with MSM, regardless of gender, is assessed as LOW to MODERATE. CDC
BoNT: Interpretation on mRNA Subject to the Select Agent Regulations
Is mRNA from botulinum neurotoxin producing species of Clostridium subject to the select agent and toxin regulations? The answer is it depends. Federal Select Agent Program
Treatment of Highly Virulent Mammarenavirus Infections
Several mammarenaviruses can cause severe human diseases with high case fatality rates and hence are considered public health and bioterrorism threats. However, due to their classification as Risk Group 4 agents, further development of identified candidate MCMs has been slow and antiviral activity evaluation of identified candidates in animal models has rarely occurred. Expert Opinion on Drug Discovery
Anticipating a MERS-Like Coronavirus as a Potential Pandemic Threat
As of March 21, 2024, there have been 2609 human cases of Middle East respiratory syndrome with 939 deaths reported to WHO since the virus was first recognized, most of which occurred in Saudi Arabia (36% case-fatality ratio). Although MERS-CoV has not progressed to a large epidemic like SARS-CoV-2, its continued circulation in camels in the Middle East, Asia, and Africa, and ongoing zoonotic transmission are a reminder of its persistent threat to global health security. The Lancet
Counterfeit ‘Botox’ Spreading Across the U.S., CDC Warns
As of April 12, 2024, a total of 19 people from 9 states have reported harmful reactions after receiving botulinum toxin injections from unlicensed or untrained individuals or in non-healthcare settings, such as homes and spas. Nine (60%) people were hospitalized and 4 (21%) were treated with botulism antitoxin. Symptoms include blurry vision, dropping eyelids, difficulty swallowing and difficulty breathing. MedPage Today, CDC
AVIAN INFLUENZA
Vietnam Reports First Human Infection with Avian Influenza H9N2 Virus
Vietnam has reported the country’s first human infection with a low pathogenic avian influenza (LPAI) A(H9N2) virus. This is a different subtype of avian influenza than the highly pathogenic avian influenza (HPAI) A(H5N1) virus that is most commonly reported globally and which is causing outbreaks in poultry and cattle in the U.S. currently. The infection in Vietnam occurred in an adult with underlying medical conditions who was hospitalized on March 16, 2024, and the patient remains hospitalized for monitoring and treatment. CDC
Avian Influenza Virus Type A (H5N1) in U.S. Dairy Cattle
Avian influenza virus type A (H5N1) has been confirmed in dairy cattle in eight states. At least 20 states have issued restrictions on the importation of dairy cattle. Several sick cats on a Texas dairy farm have tested positive for avian influenza virus type A (H5N1). This is not surprising, as cats are among the mammals previously known to contract the virus, but it reinforces the importance of keeping pets away from wild birds. American Veterinary Medical Association (AVMA), CDC 19 April Update
Risk of Bird Flu Spreading to Humans is ‘Enormous Concern’, Says WHO
Cows and goats joined the list of species affected last month – a surprising development for experts because they were not thought susceptible to this type of influenza. “The great concern of course is that in … infecting ducks and chickens and then increasingly mammals, that virus now evolves and develops the ability to infect humans and then critically the ability to go from human to human.” The Guardian
Recommendations for Worker Protection and Use of PPE to Reduce Exposure to Novel Influenza A Viruses
Any person working with or exposed to animals such as poultry and livestock farmers and workers, backyard bird flock owners, veterinarians and veterinary staff, and responders should take steps to reduce the risk of infection with avian influenza A viruses associated with severe disease when working with animals or materials potentially infected or confirmed to be infected with these viruses. CDC
CHEMICAL + RADIOLOGICAL THREATS
Effective Skin Decontamination with RSDL Following Exposure to a Novichok Nerve Agent
As the properties of Novichok agents are different from the ‘classical’ nerve agents, such as VX, research is needed to evaluate whether and to what extent existing countermeasures are effective. In this study, the Reactive Skin Decontamination Lotion (RSDL) kit was highly effective in preventing intoxication, even when applied up until 30 minutes following exposure. Delayed use of the RSDL kit until the appearance of clinical signs of intoxication (3-4 hours) was not effective. Chemico-Biological Interactions
NBC Protective Clothing with Activated Carbon to Neutralize Sarin
This investigation delves into the development of cupric oxide functionalized activated carbon fabrics as a filter material for self-decontaminating protective clothing designed to counter chemical warfare agents (CWAs). Composite Interfaces
Hydrogen-Bond Acidic Materials in Acoustic Wave Sensors for Nerve Chemical Warfare Agents’ Detection
The latest trends in the field of the on-site detection of chemical warfare agents involve increasing the availability of point detectors to enhance the operational awareness of commanders and soldiers. Among the intensively developed concepts aimed at meeting these requirements, wearable detectors, gas analyzers as equipment for micro- and mini-class unmanned aerial vehicles (UAVs), and distributed sensor networks can be mentioned. One of the analytical techniques well suited for use in this field is surface acoustic wave sensors, which can be utilized to construct lightweight, inexpensive, and undemanding gas analyzers for detecting CWAs. Sensors
SURVEILLANCE + DETECTION
Ranking Technologies for Managing Indoor Pathogen Transmission
What are the most promising current and emerging technologies for being up to the task when the next airborne disease like COVID-19 hits? In a JRC-HERA study, well-established filtration and ventilation topped the list of the highest-impact existing technologies. UV radiation and nucleic acid amplification came next in the impact ranking. Further development of plasma-based inactivation, aerosol samplers, biosensors, and direct identification through physico-chemical properties each carry pros and cons to be weighed for prioritization. EU Science Hub
Evaluation of Sponge Wipe Surface Sampling of Bioterrorism Agent Surrogates
This study evaluated the efficacy of sponge wipe sampling at recovering potential bacterial surrogates for Category A and B non-spore-forming bacterial bioterrorism agents from hard nonporous surfaces. Mean recoveries from persistence testing indicated that three microorganisms (Yersinia ruckeri, Escherichia coli, and Serratia marcescens) demonstrated sufficient persistence across all tested material types. Journal of Applied Microbiology
Evaluation of Water Treatments on Surfaces to Inhibit Bacterial Spore Resuspension
The impact of water and the wet–dry cycle was examined as a potential mitigation solution to pathogenic bacterial spore transport and inhalation risk via resuspension of spores from surfaces due to human activities. This research demonstrates that treating surfaces with water to inhibit spore resuspension could be a valuable tool in exposure minimization and remediation after a bioterrorism event. Remediation Journal
NAMRU SOUTH Conducts Ongoing Febrile and Respiratory Disease Surveillance
Researchers from U.S. Naval Medical Research Unit (NAMRU) SOUTH have an ongoing collaboration with local Peruvian hospitals to surveil pathogens causing febrile (having to do with fever) and respiratory diseases. The aim of these studies, funded by DoD Global Emerging Infections Surveillance (GEIS), is to identify the specific causes of acute respiratory and febrile illnesses found in patients at military and civilian health facilities across the U.S. Southern Command. Navy Medicine
Accelerated Development of a COVID-19 Lateral Flow Test in an Academic Setting: Lessons Learned
This account aims to provide a concise overview of an 18-month sprint toward the practical development of a deployable antigen lateral flow assay under pandemic conditions. The authors highlight what it takes to coach a technically savvy but commercially inexperienced academic team through the accelerated translation of an early stage technology into a useful product. Accounts of Chemical Research
INFECTIOUS DISEASES
WHO Prequalifies New Oral Simplified Vaccine for Cholera
The inactivated oral vaccine Euvichol-S has a similar efficacy to existing vaccines but a simplified formulation, allowing opportunities to rapidly increase production capacity. Currently, 23 countries are reporting cholera outbreaks with most severe impacts seen in the Comoros, Democratic Republic of the Congo, Ethiopia, Mozambique, Somalia, Zambia and Zimbabwe. World Health Organization
COVID-19 PANDEMIC
A New mAb for COVID-19 Pre-Exposure Prophylaxis: Knowns and Unknowns
In March 2024, a new mAb, pemivibart (Pemgarda), received EUA for PrEP in moderate-to-severely immunocompromised persons ≥12 years. This drug is derived from the parent mAb adintrevimab and is authorized as a 4,500 mg intravenous infusion every 3 months. There are no published effectiveness data to date; rather, pemivibart’s approval was based on an “immunobridging” approach, similar to that used for vaccines. IDSA
Hippos Get COVID Too
A new research paper characterizes the binding properties of hippopotamus ACE2 to SARS-CoV-2. Understanding the invasion mechanism of SARS-CoV-2 will provide important information for the surveillance of SARS-CoV-2 in hippopotami, as well as other semi-aquatic mammals and cetaceans. Journal of Virology
SPECIAL INTEREST
Highlights from the 23rd Annual Meeting of the Rocky Mountain Virology Association
Summary of key scientific sessions from the 2023 event covering viral evolution and surveillance, developments in prion research, arboviruses and vector biology, host–virus interactions, and viral immunity and vaccines. Viruses
Nominate an Expert: Biological Threats in the Age of the Bioeconomy
The National Academies is seeking suggestions for experts to participate in a new workshop series that discusses adaptation of existing frameworks for assessing and reducing dual-use potential of biological research to bioeconomy-related research and development efforts. Submissions are due 27 April. National Academies
IN MEMORIAM
Remembering Joel Breman, Ebola Pioneer and Beloved Global Health Mentor
Joel Breman, a leader in efforts to control smallpox, Ebola, malaria and several other infectious diseases, died this month in Chevy Chase, Maryland, at the age of 87. Breman worked on guinea worm, onchocerciasis, polio, measles and malaria at the CDC, the National Vaccine Program Office and the NIH Fogarty Center. He trained scientists, wrote books and published articles in medical journals. His first publication came in 1969, and his final publication was in October 2023. NPR
ALSO READING
Vaccine adjuvants: Current status, research and development, licensing, and future opportunities. Journal of Materials Chemistry B
Influenza antibody breadth and effector functions are immune correlates from acquisition of pandemic infection of children. Nature Communications
Viral shedding and viraemia of Andes virus during acute hantavirus infection. The Lancet Infectious Diseases
Centering law in public health education. Health Affairs
High tech business entry in the pandemic era. Federal Reserve
Biosafety regulations are not yet fit for purpose. The Lancet
Rapid detection of monkeypox virus and differentiation of West African and Congo Basin strains. Analytical Methods
Johns Hopkins APL tools drive insight and decision-making in Ebola outbreak response. JHU APL