News highlights on health security threats and countermeasures curated by Global Biodefense
This week’s selections include another year to negotiate a Pandemic Treaty, new funding for H5N1 response, a WHO report on the future of variola virus research, and studies on Nipah vaccine development.
POLICY + GOVERNMENT
WHO Member Countries Approve Steps to Bolster Health Regulations to Better Brace for Pandemics
The World Health Organization said member countries on Saturday approved new steps to improve global preparedness for and response to pandemics like COVID-19 and mpox, and set a new deadline for agreeing on a broader treaty with the goal of reaching consensus by the next World Health Assembly in May 2025. AP, European Commission, PAHO
The Pandemic Treaty Will Succeed Only with Investment to Build Strong Health Systems
The status quo of siloed investments focused on specific diseases is unsustainable. Billions in investments have not yet built the resilience required for the challenges ahead. Investing in strong health systems — which means investing in the health workforce — solves many of the most pressing challenges at once. Any hard-won agreements in a Pandemic Treaty risk failing if strong health systems are not in existence to leverage the treaty’s results. STAT
‘Preposterous’: Anthony Fauci Denies Cover-Up Of COVID Origins During Tense Hearing
As has been the case at most of the hearings, the questioning during Fauci’s session reflected a deep political divide in the US government. Republicans criticized Fauci’s oversight of both NIAID-funded research grants and the institute’s staff members, and alleged that he coordinated a cover-up of the pandemic’s origins. Republicans also ripped into Fauci’s promotion of masking, vaccination and social distancing during the pandemic. By the end of 2024, the US House of Representatives Select Subcommittee on the Coronavirus Pandemic will release a final report with the findings and recommendations of its two-year investigation. Given the intense partisanship shown at the hearings, it’s unlikely the findings will do much to help the nation prepare for future pandemics. Nature
Lab Group Sues FDA Over Final Rule Regulating Laboratory-Developed Tests
The U.S. trade group representing laboratory companies and test manufacturers is suing to block the FDA from increasing its oversight of lab-developed tests, saying the agency overstepped its authority when it announced it would regulate all in vitro diagnostics with largely the same approach it uses for medical devices. The ACLA argued that new congressional legislation should be the only method to increase the FDA’s oversight of LDTs, and that testing services are already regulated under the Clinical Laboratory Improvement Amendments, commonly known as CLIA. Fierce Biotech, STAT
USDA Announces New Funding to Protect Livestock Health; Launches Voluntary H5N1 Dairy Herd Status Pilot Program
The USDA is adding an additional $824 million in emergency funding to bolster outbreak response and preserve livestock health; and is launching a new Voluntary H5N1 Dairy Herd Status Pilot Program, which provides alternative testing and movement options to the Federal Order to increase USDA’s monitoring capabilities to mitigate the spread of H5N1. USDA
FDA Set to Reorganize Its Food Division Starting in October
The reorganization will lead to the creation of a unified Human Foods Program (HFP) and the adoption of a new model for the FDA’s field operations among other changes. The HFP will take over the roles of the Center for Food Safety and Applied Nutrition (CFSAN) and the Office of Food Policy and Response, along with key functions from the Office of Regulatory Affairs, which will be renamed to the Office of Inspections and Investigations. The FDA announced the HFP’s establishment last year after being criticized for not providing enough resources in wake of an extended infant formula shortage. Reuters
MEDICAL COUNTERMEASURES
Safety and Immunogenicity of a Nipah Virus Vaccine (Hev-Sg-V) in Adults
This Phase 1 enrolled 192 participants, All three doses and regimens of the vaccine candidate administered were found safe and immunogenic. The induction of antibodies within one month of vaccination, along with the persistence afforded by two dosages, suggests the vaccine candidate has potential for reactive outbreak control and preventative use. SSRN
Nano-Assembled Polyphosphazene Delivery System Enables Effective Intranasal Immunization with Nipah Virus Subunit Vaccine
A polyphosphazene-enabled intranasal Nipah vaccine candidate demonstrates the ability to induce immune responses in hamsters and shows superiority in inducing total IgG and neutralizing antibodies when benchmarked against the respective clinical stage alum adjuvanted vaccine. ACS Applied Bio Materials
CEPI Teams Up with Korea’s Pandemic Agency to Fight Future Disease Outbreaks
The Memorandum of Understanding signed 28 May outlines a joint commitment to work together and accelerate the development of vaccines and other biological countermeasures against public health threats. This includes known infectious diseases like Middle East Respiratory Syndrome (MERS), Ebola, and mpox as well as a future but as-yet-unknown pathogen with pandemic potential, ‘Disease X’. CEPI and KDCA intend to collaborate on scientific research projects and laboratory capacity-building. CEPI
Hexestrol, an Estrogen Receptor Agonist, Inhibits Lassa Virus Entry
Lassa virus (LASV) is the causative agent of human Lassa fever which in severe cases manifests as hemorrhagic fever leading to thousands of deaths annually. However, no approved vaccines or antiviral drugs are currently available. Recently, we screened approximately 2,500 compounds using a recombinant vesicular stomatitis virus (VSV) expressing LASV glycoprotein GP (VSV-LASVGP) and identified a P-glycoprotein inhibitor as a potential LASV entry inhibitor. Journal of Virology
Two Noncompeting Human Neutralizing Antibodies Targeting MPXV B6 Show Protective Effects Against Orthopoxvirus Infections
Here researchers isolated two potent neutralizing mAbs against MPXV B6 from a smallpox-vaccinated individual. Both mAbs can cross-react to several orthopoxviruses including monkeypox, vaccinia, variola, and cowpox viruses and exhibited efficient antiviral activities against vaccinia infections in vitro and in vivo, indicating their potential as broad therapeutics for treatment of mpox and other related diseases. Nature Communications
BioNTech Secures $145M to Boost mRNA Vaccine Capabilities in Africa
BioNTech expanded its strategic partnership with the Coalition for Epidemic Preparedness Innovations (CEPI), securing $145 million in funding to boost its mRNA vaccine footprint in Africa. The investment will help improve the clinical and commercial-scale manufacturing capacity of the facility in Kigali, Rwanda, with the goal of boosting regional capacity for end-to-end research, development and rapid manufacturing of mRNA vaccines in Africa. BioSpace
BIOSECURITY + BIOPREPAREDNESS
A New Mechanism for Expanding Access to Essential Countermeasures
As the world comes together through the WHO design and consultation process on a new medical counter-measures platform, we propose an enhanced APT-A (Access to Pandemic Tools Accelerator) that builds on the previous architecture but includes two new pillars – one for economic assistance and another to combat structural inequalities for future pandemic preparedness and response. Health Economics, Policy and Law
Ready or Not 2024: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism
Transcript and on-demand presentation from the May 29 Ready or Not 2024 Congressional Briefing and National Webinar. The report found that while emergency preparedness has improved in some areas, policymakers not heeding the lessons of past emergencies, funding cuts, and health misinformation put decades of progress at risk. Trust for America’s Health
MIT Researchers Ordered and Combined Parts of the 1918 Pandemic Influenza Virus. Did They Expose a Security Flaw?
Researchers at MIT conducted a “red team” test of industry safety measures, arriving at what they characterize as an alarming conclusion. They were able to order and receive all the genetic material necessary to recreate the 1918 pandemic influenza virus and the toxin ricin. On their face, the results of the study appear concerning. But The International Gene Synthesis Consortium (IGSC) argues that the study is misleading and the system worked as designed: a legitimate individual ordered DNA sequence that, by itself, posed no risk of misuse, for delivery to a company associated with legitimate scientific contributions directly relevant to the sequence that was ordered. Bulletin of the Atomic Scientists
SELECT AGENTS + PRIORITY PATHOGENS
Lack of Transmission of Chronic Wasting Disease Prions to Human Cerebral Organoids
CWD is a cervid prion disease with unknown zoonotic potential that might pose a risk to humans who are exposed. To assess the potential of CWD to infect human neural tissue, researchers used exposed human cerebral organoids with high concentrations of 2 different genotypes of CWD inocula from 3 different sources for 7 days, then screened for infection for up to 180 days. The unsuccessful propagation of CWD in cerebral organoids supports a strong species barrier to transmission of CWD prions to humans. Emerging Infectious Diseases
Fate and Transport of Viable Bacillus Anthracis Simulant Spores in Ambient Air
Details of a Wide Area Demonstration (WAD) field exercise conducted in 2022 aimed to operationalize aspects of remediation activities that would occur following an outdoor release of Bacillus anthracis spores, including sampling and analysis, decontamination, data management, and waste management. Journal of the Air & Waste Management Association
Looking Beyond the Lens of Crimean-Congo Hemorrhagic Fever in Africa
CCHF) is a lethal viral disease that has severe public health effects throughout Africa and a case fatality rate of 10%–40%. The shortage of diagnostic tools, ineffective tick control efforts, slow adoption of preventive measures, and cultural hurdles to public education are among the problems associated with continued CCHF virus transmission. Emerging Infectious Diseases
Potential of Plant-Produced Virus-like Particle Vaccines for African Horse Sickness
With a warmer climate, the incursion of AHSV into southern Europe and elsewhere may become more commonplace, with environmental conditions more suitable for insect vectors and viral transmission. The potential of VLP vaccines to facilitate plug-and-play functionality offers a rapid-response capability, and the use of a plant expression system can ensure that production is not limited to expensive facilities, which limits access for developing countries where the need may be greatest. Pathogens
Epidemiological Investigation of Yersinia pestis, Francisella tularensis, and Arenavirus Infections in Small Mammals in Northwestern Iran
F. tularensis was the only zoonotic agent detected in rodents captured in East Azerbaijan. However, the diversity of trapped rodents and fleas provides the potential for the spread of various rodent-borne viral and bacterial diseases in the studied areas. Vector-Borne and Zoonotic Diseases
Report from WHO Advisory Committee on Variola Virus Research
The WHO Advisory Committee on Variola Virus Research (ACVVR), held its twenty-fifth meeting on 25-26 October 2023. The recommendations of the Committee are summarized in this report, released last week. The Committee noted that with the approval of a third antiviral agent and a fourth generation vaccine, the original objectives of the research programme endorsed by the World Health Assembly (WHA) were being met. Countermeasures developed for smallpox preparedness have been key in responding to the global mpox outbreak, illustrating the continuing potential public health benefit of the variola virus research programme. Nonetheless, signals of resistance to tecovirimat in a few cases of mpox were concerning and the Committee noted that continued development of therapeutics with different mechanisms of action is warranted. WHO
As Mpox Cases Rise, Experts Urge Complete, 2-Part Vaccinations
The number of U.S. mpox cases has more than doubled compared with last year (from 434 at that time last year to 1,089 this year), and the CDC has been urging clinicians across states to encourage vaccinations for those at risk. About a third of the cases are in New York state, New Jersey and Pennsylvania. Those who are at highest risk for mpox, including men who have sex with men and people with advanced HIV, should receive two doses, four weeks apart, of the Jynneos vaccine to prevent infection. Stateline
AVIAN INFLUENZA
NIAID Research Agenda for 2024 H5N1 Influenza
The research agenda focuses on four key objectives: increasing understanding of the biology of H5N1 viruses and the factors that influence their ability to transmit and cause disease; developing and evaluating prevention strategies, such as vaccines; advancing existing and novel treatments, including antivirals and monoclonal antibodies; and supporting strategies for detecting H5N1 virus. NIAID
Finland to Offer Bird Flu Vaccine to Select Groups of People, a Possible Global First
Finland is preparing to offer vaccines to people at risk of exposure to an avian influenza strain spreading among farmed and wild animals, health officials there said, potentially becoming the first country to take such a step as concerns about the threat the virus poses to people intensify. STAT
Antibodies to Influenza A(H5N1) Virus in Hunting Dogs Retrieving Wild Fowl, Washington State
Study detected antibodies to H5 and N1 only in hunting dogs with high levels of bird hunting and waterfowl retrieval. Although that finding suggests transmission of HPIAV H5N1 from waterfowl to dogs can occur, low seroprevalence, lack of reported disease in seropositive dogs, and lack of evidence for dog-to-dog transmission among dogs sharing households collectively indicate that the subclade 2.3.4.4b HPIAV H5N1 strains that circulated in North America during 2022–2023 were poorly adapted to dogs. Effective risk communication with hunting dog owners could be an inexpensive and effective strategy to reduce the potential for spillover to dogs. Emerging Infectious Diseases
Outbreak of Highly Pathogenic Avian Influenza A(H5N1) Viruses in U.S. Dairy Cattle and Detection of Human Cases — United States, 2024
Approximately 350 exposed farm workers are being monitored; one of the two cases was identified via daily, active monitoring. Surveillance has identified no unusual influenza activity trends in the United States. A(H5) candidate vaccine viruses are available, and laboratory analyses indicate that A(H5N1) viruses circulating in cows and other animals are susceptible to FDA-approved antivirals. MMWR
Alpacas Test Positive for H5N1 Bird Flu for the First Time
The National Veterinary Services Laboratories (NVSL) announced on 28 May the first confirmed detection of HPAI in alpacas from a location experiencing an outbreak in poultry. The viral genome sequence for the alpaca samples is the same sequence currently circulating in dairy cattle (B3.13), which is consistent with sequences from the depopulated poultry on this premises. There are more than 264,000 alpacas registered in the US, according to the Alpaca Owners Association. USDA, CNN
Why Bird Flu is Infecting People’s Eyes
Cases of avian flu causing conjunctivitis are not that rare. There was a large outbreak of H7N7 avian flu in poultry in the Netherlands in 2003, which led to 89 confirmed human cases. Of these, 78 people had conjunctivitis. “We’ve seen this [conjunctivitis] also before with … H7N7 viruses quite a lot and a little bit less with H5 bird flu viruses. But we know that these bird flu viruses can cause conjunctivitis rather easily.” Scientific American
These Are the Bird Flu Questions That Influenza and Animal Scientists Desperately Want Answered
It’s not lost on many scientists, here and abroad, that the paucity of data coming out of the U.S. is not dissimilar to the limited information flow out of China in the early days of the Covid-19 pandemic — a situation the U.S and other governments complained about loudly. Is the virus transmitting between dairy cows via the milking process? How widespread is it in herds? Can cows be reinfected? Would vaccinating herds stop transmission? How does route of infection correlate to severity of illness? Will H5N1 become established in cattle? STAT
What’s Next for Bird Flu Vaccines?
We would need more than 600 million doses to cover everyone in the US, at two shots per person. And the process we typically use to produce flu vaccines takes months and relies on massive quantities of chicken eggs. Yes, chickens. One of the birds that’s susceptible to avian flu. Talk about putting all our eggs in one basket. MIT Technology Review
CHEMICAL + RADIOLOGICAL THREATS
Chloropicrin and Its Alleged Use in the Ukrainian War (Part 2)
This second instalment looks into the specific allegation of chloropicrin use. Despite the US assertion, only three such claims from Ukrainian sources are public, but concrete evidence of when, where and how the chloropicrin was used is lacking. Notwithstanding, the allegation cannot be entirely dismissed. In April 1989, Soviet troops violently broke up demonstrations in the Georgian capital Tbilisi. The three RCAs they used? CS, CN and chloropicrin. The Trench
Pulmonary Rehabilitation In Iranian Outpatients with Mustard Gas Lung Disease
60 men with breathlessness due to respiratory disease caused by documented mustard gas exposure participated in the trial. These data suggest that pulmonary rehabilitation can improve exercise capacity and quality of life in people with breathlessness due to mustard gas lung disease and support the wider provision of this form of care. BMJ Open
Multiwell-Based G0-PCC Assay for Radiation Biodosimetry
In cytogenetic biodosimetry, assessing radiation exposure typically requires over 48 hours for cells to reach mitosis, significantly delaying the administration of crucial radiation countermeasures needed within the first 24 hours post-exposure. This is the first attempt to combine Convolutional Neural Networks (CNN) with this type of assay for radiation biodosimetry. By training CNNs with a dataset of labeled images of both control and irradiated PCC cells, the network identified chromosomal changes induced by radiation, addressing challenges of manual analysis. These modifications significantly reduced our previous test turnaround time from 54 hours to approximately 7-9 hours, significantly improving response capability in emergency radiation exposure scenarios. BioRxiv
SURVEILLANCE + DETECTION
Real-Time PCR Assays That Detect Genes for Botulinum Neurotoxin A–G Subtypes
The botulinum neurotoxins are an extremely diverse group of protein toxins, and this presents challenges when designing RT-PCR assays, where a single nucleotide mismatch in either the forward or reverse primer or the probe sequence may be the difference between successful detection and failure to detect the toxin gene. The goal of this study was to design, test, and evaluate Real-Time TaqMan PCR assays for the detection of botulinum neurotoxin (bont/A-G) genes from currently recognized BoNT subtypes. Frontiers in Microbiology
Development of an Antigen Capture Lateral Flow Immunoassay for the Detection of Burkholderia pseudomallei
Early diagnosis is essential for the successful management of Burkholderia pseudomallei infection, but it cannot be achieved by the current gold standard culture technique. This study aimed to develop an LFIA targeting B. pseudomallei capsular polysaccharide. The prototype assay performed well in hemoculture medium, but was not sensitive enough in urine samples. Diagnostics
Wastewater: Between Surveillance and Intrusion
A cryptic lineage of SARS-CoV-2 was identified during routine wastewater surveillance (WWS) in which the investigation narrowed down the source from over 100,000 to about 30 individuals. This raised conflicting ethical concerns. On the one hand, further investigations could have led to the identification of the individual shedding the virus, infringing on the privacy of their health data, accessed without consent. On the other hand, the individual shedding the virus was deemed likely to have an undiagnosed chronic SARS-CoV-2 infection, making a moral case for facilitating linkage to care. The study encapsulates some of the key ethics dimensions in WWS of infectious diseases, for which a specific ethical framework has not yet been formalized. The Lancet Microbe
Exploring Monkeypox Virus Proteins and Rapid Detection Techniques
A comprehensive discussion of the roles of various proteins, including extracellular enveloped virus (EEV), intracellular mature virus (IMV), and profilin-like proteins of mpox. It also highlights recent diagnostic techniques based on these proteins to detect this infection rapidly. Frontiers in Cellular and Infection Microbiology
Long-Term Wastewater Monitoring of SARS-CoV-2 Viral Loads and Variants at a Major International Airport
Wastewater surveillance for SARS-CoV-2 was performed at Amsterdam Schiphol Airport, showing the feasibility of monitoring throughout the pandemic irrespective of other measures. Viral load trends paralleled and sometimes predated Dutch national viral load trends. VOC emergence mirrors and at times predates those reported in clinical samples. Science of the Total Environment
Diagnostic Chip for the Colorimetric Detection of Legionella at Point of Need
A simple, compact chip for the rapid detection of L. pneumophila in water samples, integrating for the first time on-chip sample preparation (by bacteria capture, lysis, and LAMP-based amplification of bacterial DNA) with naked-eye or image analysis-based semiquantitative end-point detection. A point-of-need platform can have a huge impact in tackling Legionella outbreaks and generally find widespread application for fast and reliable waterborne-bacteria detection. Biosensors
A Genomics Costing Tool Focused on Next Generation Sequencing
WHO is working with countries and partners to implement the Global Genomic Surveillance Strategy for Pathogens with Pandemic and Epidemic Potential 2022–2032. A key technical product developed through these multi-agency collaborative efforts is a genomics costing tool (GCT), which obtains costs of routine sequencing and bioinformatics activities and builds an investment case for the scale-up or establishment of sequencing and bioinformatics activities. Frontiers in Public Health
INFECTIOUS DISEASES
Varicella Outbreak Among Recent Arrivals to New York City, 2022–2024
This chickenpox outbreak was identified in October 2022 and is ongoing as of March 8, 2024. Most cases (70.6%) have occurred among children and adolescents; however, a substantial number of cases occurred among adults aged >18 years. Many recent migrants in NYC arrived from countries that do not have a routine varicella vaccination program and have a high incidence of varicella. Approximately 27,000 varicella-containing vaccine doses have been administered to recently arrived migrant children, adolescents, and adults, by vaccination vendors deployed by New York City Department of Health and Mental Hygiene (DOHMH) together with NYC’s public hospital system. MMWR
Cuba Reports Oropouche Virus Cases
Cuba’s health ministry this week announced the detection of Oropouche virus cases in two cities in Santiago province in the southeastern part of the country. The Pan American Health Organization (PAHO) has warned of rising Oropouche virus cases in some Americas countries, with cases this year reported from Brazil, Bolivia, Colombia, and Peru. Oropouche fever is an emerging zoonotic disease circulating in South and Central America. During the last 60 years, more than 30 epidemics and over half a million clinical cases attributed to OROV infection have been reported in Brazil, Peru, Panama, Trinidad and Tobago. CIDRAP
EMA Publishes Reflection Paper on Creutzfeldt-Jakob Disease and Plasma-Derived and Urine-Derived Medicinal Products
In this reflection paper, the European Medicines Agency (EMA) removed a recommendation that donors who have spent a cumulative period of 1 year or more in the UK between 1980 and the end of 1996 should be excluded from donating plasma due to the risk of variant Creutzfeldt-Jakob disease (vCJD). In May 2022, the U.S. FDA removed the last of its similar ban. vCJD in the U.K. peaked at 28 cases in 2000 and has decreased each year since. The last two reported deaths from vCJD in the U.K. were in 2013 and 2016. As of April 2021, there has been a total of 232 cases of vCJD worldwide, with 178 in the U.K., 28 in France, four in Ireland, four in the United States (all with histories of overseas residency), and 18 cases in eight other countries. ECDC
New Measures to Tackle the Global Cholera Surge
The rollout of rapid diagnostic tests and a new vaccine offer some promise in the fight against the growing number of cholera outbreaks worldwide. Cholera is both treatable and preventable, and decades of progress against the disease had raised hope in 2017 that cholera could be eliminated in several countries by 2030. However, this target currently seems impossible, due to the unprecedented increase in the number of cholera cases and fatalities globally since 2021, which does not seem to be abating. The Lancet Microbe
Increased Parvovirus B19 Activity in Europe, ECDC Emphasizes Enhanced Awareness
B19V is the cause of a common childhood disease, typically presenting with mild symptoms such as fever, rash, and joint pain. Pregnant women and immunocompromised patients are at increased risk of complications. Since March 2024, nine EU/EEA countries have reported unusually high increased numbers of B19V on the European surveillance portal for infectious diseases, EpiPulse, from a number of monitoring systems, mostly during late 2023 and early 2024. ECDC
Gonorrhea Cases Reach Record High In England
Diagnoses rose 7.5% – from 79,268 in 2022 to 85,223 in 2023. Syphilis, meanwhile, rose 9.4% – from 8,693 to 9,513, the highest number since 1948 – with more heterosexual men and women becoming infected. Untreated syphilis can cause lifelong complications, such as brain and nerve problems, while gonorrhea can lead to infertility. BBC
Why It’s So Challenging to Develop Vaccines for Parasitic Diseases
Most of the neglected tropical diseases, including leishmaniasis and Chagas disease, are parasitic diseases. The process of making vaccines for parasites is extremely challenging – but scientists might be on the cusp of major breakthroughs. BBC
COVID-19 PANDEMIC
COVID Shots Could Use Another Update, Study Suggests
Data appeared to point to lower effectiveness against infection, hospitalization, and death after the arrival of the JN.1 subvariant, the dominant strain in the U.S. through the end of March of this year. The FDA’s Vaccines and Related Biological Products Advisory Committee is set to meet on June 5 to discuss and make recommendations on the selection of the formula for the 2024-2025 season. Signs point to the selection of JN.1 or one of its newer descendants such as KP.2, which currently accounts for an estimated 29% of U.S. cases. MedPage Today
Comparison of Morbidity and Absenteeism Due to COVID-19 and Seasonal Influenza in a Large Cohort of Healthcare Personnel
As SARS-CoV-2 becomes endemic, COVID-19 remains the prevalent cause of morbidity and absenteeism among HCP, accounting for considerably more workdays missed compared with influenza. Overall, in this study group COVID-19 accounted for 4245 days missed during the study period compared with 333 days missed due to influenza. AJIC
NIH Documents Show How $1.6 Billion Long Covid Initiative Has Failed So Far to Meet Its Goals
More than three years ago, the NIH launched a $1 billion-plus initiative to find the root causes and potential treatments for long Covid. But a lack of visible progress from the initiative, called RECOVER, has drawn months of criticism from patient advocates, researchers, and lawmakers, including at a Senate hearing last week on the NIH’s budget. Experts who reviewed the contracts and project documents say the agency set itself up for failure by not selecting scientists with “an established background in conducting research on post-acute infection syndromes” such as myalgic encephalomyelitis (ME). STAT
Applying Lessons of COVID-19 and Other Emerging Infectious Diseases to Future Outbreaks
The role of randomized control trials (RCT) in the response to EIDs needs to be carefully considered. RCTs are regarded as the gold standard of evidence. However, without a thorough understanding of the condition being studied and how it impacts important subpopulations, RCTs can lead to erroneous conclusions (15, 16). Moreover, the cost and complexity of executing RCTs are high, frequently requiring sponsorship from for-profit pharmaceutical companies. Although well positioned to bring new drugs to market, these companies put stringent limits on the types of studies that they are willing to support. For example, immunocompromised patients were disproportionately impacted by the COVID-19 pandemic yet comprised a very small percentage of participants in RCTs. At the other extreme, immunocompetent patients with broad immunity against SARS-CoV-2 (e.g., through natural infection and/or vaccination) are also understudied. mBio
Three-Year Outcomes of Post-Acute Sequelae of COVID-19
A cohort of 135,161 people with SARS-CoV-2 infection and 5,206,835 controls from the US Department of Veterans Affairs who were followed for 3 years to estimate risks of death and PASC. Among non-hospitalized individuals, the increased risk of death was no longer present after the first year of infection; among hospitalized individuals, risk of death declined but remained significantly elevated in the third year after infection. Risk of incident PASC declined over the 3 years, but substantial residual risk remained in the third year for patients that had been hospitalized for COVID-19. Nature Medicine
HISTORICAL REFLECTIONS
It Wasn’t Just Rats. Body Lice May Have Helped Spread Bubonic Plague.
The bubonic plague pandemic of the 14th century gained infamy as much for its death toll — 25 million in Europe alone — as for the horror of the disease itself. Scientists have long blamed rat-transmitted fleas for the plague’s swift spread. But recent research points the finger at an additional culprit: body lice. Washington Post
Antimicrobial Therapies Administrated During the Third Plague Pandemic in Europe
An overview of the natural history and pathogenicity of Yersinia pestis, the bacterium responsible for plague, its spread from Asia to Europe during the Third Pandemic (1896-1945), and the therapies used to treat and prevent the disease in Europe, with particular focus on the case of Taranto. In Taranto, the Pasteur Institute’s antiserum antimicrobial therapy, and vaccination were used to treat and stop the advance of the bacterium, with mixed results. Infections in the History of Medicine
Why We Are Still Debating the “Origin” of the Black Death
In 1998, molecular geneticists first announced that they had retrieved fragments of the genetic material of Yersinia pestis from sites that had historically been associated with outbreaks of pestilencia. That announcement was in fact followed by a decade of debate about what constituted good methods in the emerging field of palaeogenetics. Now that plague history is being investigated at the level of bacterial evolution—a level of analysis that has never been possible before, save at the level of sheer speculation—historians (who previously have worked solely at the level of human perception) now have to think about bacterial histories as well as the political, economic, and social histories of humans, as well as larger environmental histories. Knowledge Commons
SPECIAL INTEREST
My Quest To Cure Prion Disease — Before It’s Too Late
Biomedical researcher Sonia Vallabh‘s life was turned upside down when she learned she had the genetic mutation for a rare and fatal illness, prion disease, that could strike at any time. Thirteen years later, her search for a cure has led to new insights about how to catch and prevent disease — and how to honor our grandest, most mysterious inheritance: our brains. TED
ALSO READING
SARS-CoV-2 in captive nonhuman primates, Spain, 2020–2023. Emerging Infectious Diseases
Highly sensitive and quantitative HiBiT-tagged Nipah virus-like particles: A platform for rapid antibody neutralization studies. Cell
Negotiating a pandemic treaty is just the first step — how will countries comply? Nature
Reducing the risk of highly pathogenic avian influenza A virus H5N1 transmission during the Hajj. Nature Medicine
Implementing an organizational culture of biosafety and biosecurity in the ŞAP Institute. Health Security
Poxviruses as agents of biological warfare: the importance of ensuring ethical standards for research with viruses. Poxviruses
Characterization of humanized mouse model of organophosphate poisoning and detection of countermeasures. Molecular Sciences
DARPins bind their cytosolic targets after having been translocated through the protective antigen pore of anthrax toxin. Scientific Reports
Tanzania’s first Marburg Viral Disease outbreak response: Describing the roles of FELTP graduates and residents. PLOS Global Public Health
Sleeper frameworks for Pathogen X: surveillance, risk stratification, and the effectiveness and safety of therapeutic interventions. The Lancet Infectious Diseases
Upcoming changes to NCBI Taxonomy Classifications. NCBI Insights