News highlights on health security threats and countermeasures curated by Global Biodefense
This week’s selections include the challenges of surging vaccine production for an H5N1 pandemic; sanctions on Russia for use of chemical weapons in Ukraine; and shifting transmission pattern of mpox in the DRC.
POLICY + GOVERNMENT
As Bird Flu Spreads in Cows, Fractured U.S. Response Has Echoes of Early Covid
Officials and experts said the lack of clear and timely updates by some federal agencies responding to the outbreak recall similar communication missteps at the start of the coronavirus pandemic. Until Wednesday, testing for H5N1 in dairy herds was voluntary and limited to cows with certain symptoms. The number of tests per farm was limited, too. That protocol provoked sharp criticism from public health experts. With growing evidence that the virus is more widespread than feared among cows, the USDA finally announced that lactating dairy cows must be tested for bird flu before moving across state lines, starting Monday. Washington Post
WHO Overturns Dogma on Airborne Disease Spread. The CDC Might Not Act on It.
If a respiratory disease spreads through inhalation, it means that people can lower their risk of infection indoors through sometimes costly methods to clean the air, such as mechanical ventilation and using air purifiers, and wearing an N95 mask. The CDC has so far been reluctant to press for such measures, as it updates foundational guidelines on curbing airborne infections in hospitals, nursing homes, prisons, and other facilities that provide health care. KFF Health News
U.S. Accuses Russia of Using Chemical Weapons in Ukraine
The State Department said Russia had used chloropicrin, a poison gas widely used during World War I, against Ukrainian forces. “The use of such chemicals is not an isolated incident and is probably driven by Russian forces’ desire to dislodge Ukrainian forces from fortified positions and achieve tactical gains on the battlefield,” the State Department said. New York Times, State Department
UNSCR 1540 at 20 Years
Obligating all UN member states to implement measures preventing the proliferation of weapons of mass destruction, delivery systems, and related materials, particularly to non-state actors, its passage in 2004 was a historic achievement by an international community shaken by the 2001 terror attacks on the United States as well as the exposure of A.Q. Khan’s nuclear proliferation activities. Plugging a gap in international law and reinforcing existing WMD non-proliferation and disarmament treaties such as the Nuclear Nonproliferation Treaty (NPT), the Biological and Toxin Weapons Treaty (BWC), and the Chemical Weapons Convention (CWC), the Resolution can claim a number of accomplishments. Stimson Center
Biden Campaign Hits Trump for Saying He Would Close Pandemic Preparedness Office.
In 2018, the Trump administration eliminated a pandemic preparedness task force. The National Security Council’s Global Health Security and Biodefense unit (established after the 2014-2015 Ebola outbreak) was disbanded during a reorganization of the council, with much of its staff leaving their posts or being absorbed into other units. A successor Office of Pandemic Preparedness and Response Policy (OPPR) was founded by the Biden Administration in 2022 to address failures in government response to the COVID-19 pandemic and prepare for future biosecurity challenges. President Biden’s reelection campaign criticized former President Trump on Tuesday after Trump said he would get rid of OPPR as well. The Hill
Reinforcing Global Biodefense: The Case for Amending the BWC
The Biological Weapons Convention is the cornerstone of the biological weapons disarmament regime, but the treaty is having difficulty keeping up with changing threats due to its decision-making process and geopolitics. The 9th Review Conference, which ended in late 2022, was far from perfect, but it provided “a glimmer of hope in an overall bleak international security environment.” This note calls for an amendment to the BWC that leverages a cooperation pillar to ensure compliance with the treaty while subsequently enhancing the legitimacy of international law, building upon a slim inertia for positive change. Rutgers Law Record (h/t Pandora Report)
AI Could Be Tapped to Design Weapons of Mass Destruction, DHS Warns
The Department of Homeland Security this week released a new report on the ways that chemical, biological, radiological and nuclear weapons could be misused via artificial intelligence, as well as new guidelines on securing critical infrastructure in the face of AI, a stipulation from President Joe Biden’s 2023 executive order on AI. NextGov, DHS
MEDICAL COUNTERMEASURES
Rethinking Antibodies for Infectious Diseases?
The COVID-19 experience, along with lingering manufacturing and delivery concerns, is prompting a harder look at the future of antibody-based treatment and prevention for infectious diseases. IAVI
Massive Amounts of H5N1 Vaccine Would Be Needed if There’s a Bird Flu Pandemic. Can We Make Enough?
With a brand-new flu virus — and H5N1 definitely falls into that category for humans — everyone will be naive. So the assumption of pandemic planners is that everyone would need two doses of vaccine in the first season of vaccinating against H5N1. That math is daunting. The vast majority of Covid deaths were in older adults; there were relatively few deaths in children. But flu infections are hardest on older adults and little kids, making the pediatric cohort a priority for vaccination. In addition, the global supply of adjuvants could be a bottleneck in any effort to vaccinate the world against H5N1, experts say. STAT
Pediatric Medical Countermeasures: Antidotes and Cytokines for Radiological and Nuclear Incidents and Terrorism
This is the first study comparing pediatric indications and dosing for medical countermeasures among commonly used references for radiological and nuclear incidents. Children are particularly vulnerable as they live ‘closer to the ground’ which increases risk from heavier-than-air fallout, as does their propensity for physical activity and tendency to explore their environment by placing objects in their mouths. Thinner skin can potentially lead to deeper beta burns. Rapid growth and cell division can lead to an increase in risk from exposure to ionizing radiation, as well as a risk for enhanced incorporation of radioisotopes. Disaster Medicine and Public Health Preparedness
Lower Dose of Mpox Vaccine is Safe and Generates Six-Week Antibody Response Equivalent to Standard Regimen
NIAID sponsored a study of dose-sparing strategies to extend limited vaccine supply. The mid-stage study enrolled 225 adults aged 18 to 50 years in the United States who had not previously been vaccinated against mpox or smallpox. NIH
Genetic Basis of Clarithromycin Resistance in Bacillus anthracis
Clarithromycin is an antibiotic recommended for the treatment and post-exposure prophylaxis of anthrax by the Centers for Disease Control and Prevention; however, little is known about the ability of B. anthracis to develop resistance to clarithromycin or the mechanism of that resistance. Microbiology Spectrum
Doxycycline, Levofloxacin, and Moxifloxacin Superior to Ciprofloxacin in Treating Anthrax Meningitis in Rabbits and NHP
Efficient treatment of anthrax-related meningitis in patients poses a significant therapeutic challenge. These findings imply that while ciprofloxacin is highly effective as a post-exposure prophylactic drug, using this drug to treat symptomatic patients should be reconsidered. In contrast to ciprofloxacin, levofloxacin and moxifloxacin were highly efficacious in treating lethal anthrax-related meningitis in rabbits and NHP (levofloxacin). This difference probably results from variances in blood–brain-barrier penetration of the different fluoroquinolones. Antimicrobial Agents and Chemotherapy
BIOSECURITY + BIOPREPAREDNESS
Public Health Preparedness: HHS Should Address Strategic National Stockpile Coordination Challenges
Recommendations included a need for ASPR to develop standard operating procedures, outlining how and when guidance documents, such as those for requesting and receiving SNS assets, are updated; and the need to bridge jurisdictional and tribal SNS coordination issues. GAO
America’s Infectious-Disease Barometer Is Off
During this outbreak, experts have called for better testing and surveillance—first of avian and mammalian wildlife, now of livestock. But federal agencies have been slow to respond. Testing of dairy cows was voluntary until last week. Now groups of lactating dairy cows must be screened for the virus before they move across state lines, but by testing just 30 animals, often out of hundreds. Testing and other protections for people who work with cows have been lacking, too. The fumbles of COVID’s early days should have taught the government how valuable proactive testing, reporting, and data sharing are. What’s more, the pandemic could have taught us to prioritize high-risk groups. The Atlantic
NBAF Leaders Say Research is Underway on Rift Valley Fever, Other Mosquito-Borne Viruses
Nearly a year after officials cut the ribbon on the National Bio and Agro Defense Facility, science has begun. NBAF deputy director Ken Burton said Monday those activities are moving forward in phases, beginning with the lowest-risk common science practices, with research to ramp up to more advanced, mission-focused science later on. The Mercury
After Downsizing Health Care for Years, Pentagon Says Medical Readiness Was a Casualty
A Defense Department internal memo obtained by NPR concluded that outsourcing didn’t actually save money but did hurt readiness. The so-called “stabilization memo” directs the Pentagon to reverse course, to bring more medical care back to its hospitals on base and increase medical staff, both to keep America’s standing army fit for duty and to make sure enough military doctors and nurses are trained up for a possible future war. NPR
Unveiling CBRNe and Counter-Terrorism Medicine Training in US Medical Schools
All United States medical schools were examined via online curriculums and queries for academic content related to CBRNe and terrorist medical counter-measures. 15 (9.8%) medical schools offered educational content related to CBRNe and terrorist counter-measures. This is in contrast to legislation following the September 11, 2001 attacks that called for high priority for such education. Prehospital and Disaster Medicine
SELECT AGENTS + PRIORITY PATHOGENS
Shifting Transmission Patterns of Human Mpox in South Kivu, DR Congo
Between Sept 28, 2023 and March 3, 2024, 226 suspected mpox cases were investigated in South Kivu. More than half of the cases were women (53.8%), a result that diverges from previous studies where men were predominantly affected, yet aligns with the current epidemiology of Clade I in Central Africa. It appears apparent that heterosexual transmission could be driving the transmission rates in this region, unlike homosexual transmission especially in MSM, which was the main driver for the high infection rates in 2022. The Lancet Infectious Diseases
From the Pain of Ebola to the Passion to Fight Lassa
“The project we’re working on is called the ENABLE study. It’s one of the largest ever epidemiological studies looking at understanding Lassa fever better. And we are just one of the countries involved, because ENABLE is a multi-national study that involves four other African countries as well as Sierra Leone. Our plan is to recruit up to a total of 5,000 participants for the study and to follow them over a period of two years so that we can deepen our understanding of the disease and the Lassa virus that causes it.” CEPI
Crimean-Congo Hemorrhagic Fever Virus for Clinicians
Crimean-Congo hemorrhagic fever virus (CCHFV) has a fatality rate of up to 62%. Despite its widespread range and high fatality rate, no vaccines or treatments are currently approved by regulatory agencies in the United States or Europe. Clinicians should become familiar with available diagnostic and management tools for CCHFV infections in humans. Emerging Infectious Diseases
INFLUENZA
What is the Pandemic Potential of Avian Influenza A(H5N1)?
Although sequencing of viruses from the patient and cattle in Texas did not ring alarm bells regarding the potential of HPAI A(H5N1) clade 2.3.4.4b for sustained human transmission, the threat of a pandemic remains high, and we urge international leaders to reach an agreement on a pandemic accord before it is too late. The Lancet Infectious Diseases
USDA Finally Releases Some H5N1 Sequences After Pressure from Scientific Community
The U.S. Department of Agriculture, which has been under pressure from scientists both at home and abroad to share more data on the H5N1 bird flu outbreaks in dairy cows, uploaded a large number of genetic sequences of the pathogen late last Sunday. The raw data sequences are from cattle, cats, chickens, skunk, racoon, grackle, blackbird, and goose. STAT, CIDRAP
USDA Says Ground Beef Tests Negative for H5N1 Bird Flu Virus
The USDA Food Safety Inspection Service collected 30 samples of ground beef from retail outlets in the states with dairy cattle herds that had tested positive for H5N1 at the time of sample collection. All samples tested negative for H5N1. In addition, FSIS is currently collecting muscle samples at FSIS-inspected slaughter facilities of cull dairy cattle that have been condemned for systemic pathologies. The samples will be analyzed by APHIS using PCR to determine presence of viral particles. Reuters, APHIS
Bird Flu is Infecting More Mammals. What Does That Mean for Us?
Many scientists worry in particular about pigs, which are susceptible to both human and avian flu strains, providing the perfect mixing bowl for viruses to swap genes. Pigs are slaughtered when very young, and newer generations, with no prior exposure to flu, are particularly vulnerable to infections. New York Times
Rapid Communication: Severe A(H1N1) Influenza Acute Encephalopathy Outbreak in Children in Italy, December 2023 to January 2024
A severe outbreak of influenza A(H1N1pdm09) infection in seven children (median age: 52 months) occurred between December 2023 and January 2024 in Tuscany, Italy. Clinical presentation ranged from milder encephalopathy to acute necrotizing encephalopathy (ANE) with coma and multiorgan failure; one child died. This report raises awareness for clinicians to identify and treat early acute encephalopathy caused by H1N1 influenza and serves as a reminder of severe presentations of influenza in young children and the importance of vaccination. Eurosurveillance
Detection of Influenza D Antibodies in Dogs
Study finds that household dogs are exposed to Influenza D virus (IDV), potentially acting as a source of infection for humans. Although IDV does not seem to cause major forms of illness in humans and is not currently regarded as an important public health threat, the possibility that some IDV strains may acquire the ability to evolve and adapt in the human host should not be disregarded. This potential risk could be higher in settings where there is more viral pressure, such as in groups with occupational exposure. Emerging Infectious Diseases
Analysis of Cow, Cat H5N1 Avian Flu Samples Raises Concerns About Spread to Other Animals
Microbiological examination of cow, milk, and cat samples early in the investigation of H5N1 avian flu in some of the first affected states found that the cats died shortly after they were fed raw colostrum from sick cows, highlighting the risk of spread from cows to other animals through contaminated milk. CIDRAP
Bat-Borne H9N2 Influenza Virus Evades MxA Restriction and Exhibits Efficient Replication and Transmission in Ferrets
Researchers show that bat H9N2 has high replication and transmission potential in ferrets, efficiently infects human lung explant cultures, and is able to evade antiviral inhibition by MxA in transgenic B6 mice. Together with its low antigenic similarity to the N2 of seasonal human strains, bat H9N2 fulfils key criteria for pre-pandemic influenza A viruses. Nature Communications
Cross-Species Spill-Over Potential of H9N2 Bat Influenza A Virus
In 2017, a novel influenza A virus (IAV) was isolated from an Egyptian fruit bat. In contrast to other bat influenza viruses, the virus was related to avian A(H9N2) viruses and was probably the result of a bird-to-bat transmission event. The ability of bat H9N2 to replicate in and transmit among ferrets may also allow for spread among and further adaptation to humans. Nature Communications
CHEMICAL + RADIOLOGICAL THREATS
Ways the Navy Can Catch Up on CBR Defense Training
The U.S. Navy is far behind the other armed services in CBR defense training and readiness for two reasons: absence of formal training requirements and a failure to prioritize and enforce policy that should provide the resources needed. Most of the U.S. homeland-based Navy, including leaders and security personnel, have no current CBR defense training, knowledge, or equipment to survive, respond to, or operate in a contaminated environment. Most commanding officers have no CBR defense specialist to advise them, and ATOs receive no formal school or training to properly address CBR threats in their antiterrorism plans. A WMD attack against a U.S. naval installation would result in catastrophic casualties because few of those who work there have any recent CBR defense training or equipment. US Naval Institute
Exposed to Agent Orange at US Bases, Veterans Face Cancer Without VA Compensation
The powerful toxic herbicide, widely used to defoliate Southeast Asian conflict areas, was also routinely used to kill weeds at domestic military bases. Those exposed to the chemicals at the bases stateside are still waiting for benefits and, in some cases, are hitting a familiar obstacle — government opacity. In February, Veteran Affairs proposed a rule that for the first time would allow compensation for Agent Orange exposure at 17 U.S. bases in a dozen states where the herbicide was tested, used or stored. Veterans’ groups argue some locations are missing from that list. KFF Health News
Philippines Working with US to Thwart Threat from Weapons of Mass Destruction
DTRA has engaged the government of the Philippines in capacity building to secure and eliminate chemical weapons, precursors, and toxic industrial chemicals. TRA worked with the Department of Trade and Industry to develop a strategic trade e-licensing platform that manages the registration and authorization of dual-use and other strategic goods. The DTRA has been holding international training workshops and courses for different Philippine government agencies such as the Department of Health and Department of Agriculture in Manila to prevent, detect, and prepare for outbreaks caused by disease-causing pathogens. Manila Bulletin
In silico Structures, Mass Spectra and Retention Indices Database Development for Purposes of Chemical Weapons Convention
Gas chromatography (GC) hyphenated with electron ionization mass spectrometry (EI-MS) is a predominant experimental technique established by Technical Secretariat of Organization for the Prohibition of Chemical Weapons (OPCW) for factual findings during on-site verification activities with sampling and analysis. OPCW Central Analytical Database (OCAD) and NIST software, including AMDIS, is the crucial part of the verification procedures. The common problem inherent in such analytical banks is that reference data is limited. To bridge these data gaps different modern chemoinformatics approaches can be used on different stages of in silico database generation. International Journal of Mass Spectrometry
SURVEILLANCE + DETECTION
Development of a Non-Infectious Control for Viral Hemorrhagic Fever PCR Assays
Assay validation is an essential component of disease surveillance testing, but can be problematic in settings where access to positive control material is limited and a safety risk for handlers. This paper details a single non-infectious synthetic control that can help develop and validate the PCR based detection of the viral causes of Crimean-Congo hemorrhagic fever, Ebola virus disease, Lassa fever, Marburg virus disease and Rift Valley fever. PLOS Neglected Tropical Diseases
Wastewater Surveillance Pilot Program in Uganda Shows Potential for Future Pandemic Monitoring
This pilot study shows that wastewater-based surveillance has the potential to be an economical and rapid alternative to case-based surveillance for COVID-19 and other infectious disease pathogens. APHL
Deloitte Acquires Gryphon Scientific Business
Deloitte announced on 29 Apr that it has acquired substantially all of the assets of Gryphon Scientific, LLC, “a leader in biosafety, biosecurity, and all-hazards preparedness and response, with experience in using artificial intelligence (AI) to enhance security and safety.” Yahoo Finance
Cell-Free Biosensor for Multiplexed Detection of Biological Warfare Agents
This study introduces a cell-free biosensor for BWA detection by converting the 16S rRNA of targeted pathogens into detectable functional protein molecules. Biosensors and Bioelectronics
Multiplex Detection of Seven Staphylococcal Enterotoxins Using LC-MS with a Novel Capture Molecule
A new method for the detection of various SEs in complex substrates was established by capture molecules combined with liquid chromatography–mass spectrometry. The two capture molecules developed in this paper are different from animal immune antibodies and can be obtained by the purification of recombinant proteins. This new approach not only yields many antibodies but also saves cost and time. Although the linearity and detection limit of the new trapping molecules were not better than that of the traditional animal-specific immune antibodies, their universality and recovery rate mean that they are potential replacements. Separations
ONE HEALTH
Climate Change and its Impact on Infectious Diseases in Asia
This narrative review outlines the evidence of the impact of climate change on infectious diseases of importance in Asia, including vector-borne diseases, food- and water-borne diseases, antimicrobial resistance and other infectious diseases. Singapore Medical Journal
INFECTIOUS DISEASES
The DRC is Seeing its Worst Mpox Outbreak — But Has No Vaccines or Treatments Yet. Why?
“I will remind everyone that in two and a half, three years of mpox response, there hasn’t been a single penny of donor money invested at a global level for controlling mpox,” adds Dr. Michael Ryan, executive director of the WHO’s Health Emergencies Programme. “So while the concerns of the world are very well known, I don’t see the concerns of the world reflected in the investment of resources needed to actually contain this virus.” NPR Goats and Soda
U.S. Lags Behind Other Countries in Hepatitis-C Treatment
Despite an arsenal of drugs, many Americans are still unaware of their infections until it’s too late. A Biden initiative languishes without Congressional approval. Few people are at higher risk of hepatitis C infection than those who are incarcerated. A recent study estimated that over 90,000 people in U.S. state prisons are infected, 8.7 times the prevalence of people outside the correctional system. New York Times
Current Epidemiology of Measles: Global Measles and Rubella Update
Slide deck from ECCMID presentation outlines the measles immunization agenda, large or disruptive measles outbreak trends, and risk profiling. During 2000-2022, measles vaccination prevented an estimated 57 million deaths worldwide. WHO
CDC Warns of E. Coli Outbreak Linked to Organic Walnuts Sold in Bulk
At least a dozen people in California and Washington have been sickened with E. coli food poisoning linked to organic walnuts sold in bulk to stores in 19 states, U.S. health officials said Tuesday. Seven people have been hospitalized and 2 people have developed hemolytic uremic syndrome. No deaths have been reported. CDC, King 5 Seattle
Subcutaneous Administration of a Monoclonal Antibody to Prevent Malaria
One injected dose of an investigational malaria monoclonal antibody was 77% effective against malaria disease in children in Mali during the country’s six-month malaria season, according to the results of a mid-stage clinical trial. “A long-acting monoclonal antibody delivered at a single health care visit that rapidly provides high-level protection against malaria in these vulnerable populations would fulfill an unmet public health need,” said Dr. Jeanne Marrazzo, director of the National Institute of Allergy and Infectious Diseases. NEJM, NIAID
COVID-19 PANDEMIC
WHO Launches Coronavirus Surveillance Network
The new CoViNet involves 36 laboratories across 21 countries, including the US Centers for Disease Control and Prevention. CoViNet expands on the WHO COVID-19 reference laboratory network established during the early days of the pandemic. Initially, the lab network was focused on SARS-CoV-2, the virus that causes COVID-19, but will now address a broader range of coronaviruses, including MERS-CoV and potential new coronaviruses. World Health Organization
COVID Vaccine Advisers Recommend Switch to JN.1 Strain
The WHO expert advisory panel has recommended that the next COVID vaccine formulations use a monovalent JN.1 lineage as the antigen. As of April 2024, nearly all (>94%) SARS-CoV-2 genetic sequences in publicly available databases are derived from JN.1, and these variants continue to displace existing XBB lineage variants. CIDRAP, WHO
Scientists Tried to Give People COVID — And Failed
None of the 35 participants in the challenge trial actually got COVID-19. The study’s results, published on 1 May in Lancet Microbe, raise questions about the usefulness of COVID-19 challenge trials for testing vaccines, drugs and other therapeutics. “If you can’t get people infected, then you can’t test those things,” says Tom Peacock, a virologist at Imperial College London. Viral strains used in challenge trials take many months to produce, making it impossible to match emerging circulating variants that can overcome high levels of existing immunity in populations. Nature
SPECIAL INTEREST
Chinese Scientist Who First Published COVID Sequence Stages Protest After Being Locked Out of Lab
Zhang Yongzhen wrote in an online post Monday that he and his team had been suddenly notified they were being evicted from their lab, the latest in a series of setbacks, demotions and ousters since the virologist published the sequence in January 2020 without state approval. “I won’t leave, I won’t quit, I am pursuing science and the truth!” he wrote in a post on Chinese social media platform Weibo that was later deleted. AP
ARPA-H Funding Opp: Improving Chatbots for Patient-Facing Applications
The Advanced Research Projects Agency for Health (ARPA-H) today launched the Chatbot Accuracy and Reliability Evaluation Exploration Topic (CARE ET) to fund the development of novel technical approaches to improve the testing and evaluation of chatbot outputs for patient-facing applications APRA-H
ALSO READING
The Australia Group and the prevention of the re-emergence of chemical and biological weapons. The Trench
Bringing New Technologies to Bear for Biosurveillance. Food Safety
Navigating time equity: Balancing urgency and inclusivity in pandemic treaty negotiations. PLOS Global Public Health
Kurdistan One Health Conference 2024 Agenda. Hawler Medical University
Modeling spillover dynamics: understanding emerging pathogens of public health concern. Scientific Reports
Positive selection underlies repeated knockout of ORF8 in SARS-CoV-2 evolution. Nature Communications
Republicans Step Up Attacks on Scientist at Heart of Lab Leak Theory. New York Times, Nature
One Health approach to Coxiella burnetii in Brazilian indigenous communities. Scientific Reports