News highlights on health security threats and countermeasures curated by Global Biodefense
This week’s selections include bird flu vaccine contracts, reports on counter-WMD readiness, anthrax medical countermeasures, and avian influenza testing roadblocks.
POLICY + GOVERNMENT
Judicial Decisions Constraining Public Health Powers During COVID-19: Implications for Public Health Policy Making
Public health legal powers have become increasingly constrained. Analyzing federal and state court decisions between March 2020 and March 2023, researchers here find that “courts often disrupted long-held assumptions about the scope of public health powers.” Health Affairs
Opinion: Here’s What Today’s African Vaccine Accelerator Launch Means
The African Vaccine Manufacturing Accelerator launched this week, as an innovative solution that will serve as a “pull” incentive to catalyze investment across Africa’s vaccine value chain. AVMA aims to invest at least $1 billion over the next 10 years, and help meet the global need for greater security of vaccine supply against key diseases. Africa CDC
New Reports Evaluate U.S. Readiness to Prevent, Counter, and Respond to Threats of Nuclear and Chemical Weapons of Mass Destruction
Two new reports highlight the strengths and limitations of U.S. efforts to prevent and counter threats from WMD, particularly in a changing terrorism threat landscape. Both reports highlight the need for the U.S. to look beyond a focus on international terrorist organizations, as the lines among domestic, foreign, nonstate, and state-supported terrorist groups have become increasingly blurred. National Academies
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Strategic Plan
Included in the plan is providing effective leadership and assistance for NCEZID’s cooperative agreements (e.g., the Epidemiology and Laboratory Capacity for Infectious Diseases (ELC), the Emerging Infections Program (EIP), Office of Advanced Molecular Detection (OAMD), and the National Wastewater Surveillance System (NWSS) to support epidemiologic investigations, laboratory infrastructure and expertise, surveillance, and prevention and intervention strategies for state, tribal, local, and territorial health departments. NCEZID
MEDICAL COUNTERMEASURES
Europe Taps CSL Seqirus to Produce Bird Flu Vaccines for Pandemic Preparedness Efforts
Right after signing on to help with bird flu pandemic preparedness efforts in the U.S., CSL Seqirus has agreed to do the same in Europe through a vaccine supply pact. The European Commission’s Health Emergency Preparedness and Response Authority (HERA) tapped CSL Seqirus to deliver 665,000 doses of its pre-pandemic bird flu vaccine for 15 European countries. Under a four-year contract, authorities can purchase up to 40 million more doses. Fierce Pharma
Dual-Modal Cellular Nanoparticles for Continuous Neurotoxin Detoxification
This study presents a dual-modal cellular nanoparticle (CNP) formulation engineered for continuous neurotoxin neutralization. In vivo studies conducted using a mouse model of STX intoxication reveal markedly improved survival rates compared with control groups. Nano Letters
Formulation of Next-Generation Polyvalent Vaccine Candidates Against Three Important Poxviruses
Study was conducted with goal of formulating multi-epitope vaccines against three evolutionary closed poxviruses (mpox, variola, volepox virus) using an integrated immunoinformatics and molecular modeling approach. Journal of Infection and Public Health
Roadblocks Confronting Widespread Dissemination and Deployment of Organs on Chips
This decade has witnessed seminal scientific developments from academic laboratories, a flurry of startups that seek to translate those platforms, and a genuine interest from pharmaceutical industry as well as regulatory authorities. The individual and collaborative efforts of these important stakeholders will undoubtedly continue to refine and mature Organ on Chip platforms. This paper discusses the complications associated with polydimethylsiloxane (PDMS), the widely used material for Organ on Chip fabrication and discuss alternatives; the engineering design process that will facilitate fully functional Organ on Chip platforms; and the pathway to adoption by the pharmaceutical industry, especially given the FDA Modernization Act 2.0. Nature Communications
Chemical Threat Agent-induced Pulmonary and Ocular Pathophysiological Mechanisms
Funding opportunity for research advancing understanding of fundamental mechanisms of chemical toxicity and to identify potential molecular/genetic targets that may be interrogated to reduce acute and/or long-term chronic adverse health effects after exposure of the lungs and eyes. Research must address the scientific priorities of the Chemical Countermeasures Research Program (CCRP). NIH
Telavancin Against Bacillus anthracis and Protection Against Inhalation Anthrax
Telavancin, a semisynthetic lipoglycopeptide antibiotic, was evaluated in this study as a novel therapeutic against anthrax disease. The low minimum inhibitory concentration against all strains tested and rapid bactericidal in vivo activity demonstrate that telavancin has the potential to be an effective alternative for the treatment or prophylaxis of anthrax infection. Antimicrobial Agents and Chemotherapy
BIOSECURITY + BIOPREPAREDNESS
Health Care Workers Are on the Frontlines of Epidemics and Carry the Greatest Burden
The cascade of burdens health care workers face during a public health crisis played out yet again during COVID-19: insufficient personal protective equipment, fatigue, hundreds of thousands of infections, harassment and stigmatization by the public as well as an uptick in mental health issues and suicides. Up to 180,000 health care workers globally have died during the COVID-19 pandemic. This is not unique to COVID-19. The lack of preparedness for outbreaks of all sizes and refusal to adequately protect health care workers creates a domino effect causing disruptions to — if not outright collapses of — health care systems. Resolve to Save Lives
Pandemic Preparedness and Responses to the 2009 H1N1 Influenza: Crisis Management and Public Policy Insights
How can social science scholarship make use of policies and actions related to pandemic preparedness and response, and 2009 H1N1 responses in particular, to generate new insights? The numerous national pandemic response processes during 2009 generated sharply differing pandemic responses. Notably, this was true even among relatively similar countries (e.g., EU member states) and, indeed, subnational regions (e.g., U.S. states). It was also true even when policymaking was dominated by epidemiological and medical experts (e.g., countries in Northwestern Europe). The studies show that global and national scientific leaders, and the pandemic response guidance or policies they made, relied mostly on pre-pandemic established ideas and practices (national ideational trajectories, or paradigms) in their pandemic response decisions. Oxford Research Encyclopedia of Politics
Bird Flu Shows World Not Ready For Future Pandemics: Report
Surging cases of bird flu among mammals, including US cattle, offer a stark warning that the world is not ready to fend off future pandemics, a report said on Tuesday, urging leaders to act quickly. “If H5N1 began to spread from person to person, the world would likely again be overwhelmed. We just aren’t equipped enough to stop outbreaks before they spread further.” Barron’s
New Report Offers Lessons on Stopping Disease Outbreaks, Amid Global Spread of H5N1
Resolve to Save Lives is releasing its “Epidemics that Didn’t Happen” report, celebrating six successful outbreak responses in 2023 and demonstrating the transformative impact of sustained investment in epidemic preparedness. Along with bird flu in Finland, the report chronicles how public health workers stopped cholera in Bangladesh, dengue fever in Somalia, Lassa fever in Ghana, Neethling disease in Cambodia, and leptospirosis in Vanuatu. In each case, investments in health systems saved lives, prevented human suffering, and safeguarded livelihoods. Resolve to Save Lives
SELECT AGENTS + PRIORITY PATHOGENS
Smallpox Biosecurity in a New Era of Technology
Even though the World Health Organization has overseen essential research with live variola virus in the United States and Russia, the world continues to debate whether these research samples should be destroyed. Real and perceived risks associated with emerging technologies, from artificial intelligence to synthetic biology, are intertwined with concerns about nations or substate actors that might seek to reintroduce native or modified smallpox. Think Global Health
Genetic Variations of African Swine Fever Virus: Major Challenges and Prospects
ASF has spread extensively globally, significantly impacting the swine industry. The complex and highly variable character of the ASFV genome makes vaccine development and disease surveillance extremely difficult. The overall trend in ASFV evolution is towards decreased virulence and increased transmissibility. This review deeply discusses the influence of these factors on viral immune evasion, pathogenicity, and the ensuing complexities encountered in vaccine development, disease detection, and surveillance. Viruses
Anthrax on a Sheep Farm in Winter — Texas, December 2023–January 2024
An unexpected anthrax outbreak occurred during winter in a Texas county adjacent to the Anthrax Triangle, a region with enzootic anthrax. Confirmatory nonculture evidence of Bacillus anthracis infection was identified in a lamb and a symptomatic patient who prepared its meat for consumption. Routine anthrax vaccination of animals is needed in this geographic region with known enzootic anthrax. MMWR
AVIAN INFLUENZA
‘We’re Flying Blind’: CDC Has 1M Bird Flu Tests Ready, but Experts See Repeat of Covid Missteps
As the outbreak grows — with at least 114 herds infected in 12 states as of June 18 — researchers said the CDC and FDA are not moving fast enough to remove barriers that block clinical labs from testing. In one case, the diagnostics company Neelyx Labs was on hold with a query for more than a month. “Clinical labs are part of the nation’s public health system,” said Alex Greninger, assistant director of the University of Washington Medicine Clinical Virology Laboratory. “Pull us into the game. We’re stuck on the bench.” KFF Health News
WHO Confirms Human Case of H9N2 Bird Flu in Child in India
The WHO confirmed on 11 June a case of H9N2 in a four-year-old child in the eastern Indian state of West Bengal. The child was admitted to the pediatric ICU of a local hospital due to persistent severe respiratory issues, high fever and abdominal cramps in February, and was discharged three months later after diagnosis and treatment. The patient initially tested positive for influenza B and adenovirus. He was discharged from the hospital on February 28 but with a recurrence of severe respiratory distress, he was referred to another government hospital and was admitted to the pediatric ICU and intubated on March 3. His nasopharyngeal swab was sent to the Kolkata Virus Research and Diagnostic Laboratory and tested positive for influenza A (not sub-typed) and rhinovirus. On April 26, the sample was sub-typed as influenza A(H9N2) through a real-time polymerase chain reaction. The patient was discharged from the hospital with oxygen support on May 1. Reuters, DevDiscourse
Man Dies After H5N2 Avian Flu in Mexico
The World Health Organization (WHO) has confirmed that a 59-year-old Mexican man with no known exposure to infected animals has died after being infected with the H5N2 subtype of avian flu. CIDRAP
H5N1: International Failures and Uncomfortable Truths
If you ask an infectious diseases specialist whether we should start worrying about influenza A H5N1, they will probably tell you that we should always be worrying about it. An influenza pandemic has long topped the list of global threats to health, and avian influenza poses a particularly serious concern. Action to curb this outbreak is needed urgently, including improving testing, surveillance, and reporting of infected animals and food products; vaccinating animal populations; transparent information sharing; developing and stockpiling human vaccine; and promoting protective measures among farm workers. The Lancet
Study Shows ‘Not Surprising’ Fatal Spread of Avian Flu in Ferrets
The CDC published results from an experimental infection study showing the H5N1 virus, which was taken from the human case-patient in Texas, spread efficiently between ferrets only through direct contact but not via respiratory droplets. “This is different from what is seen with seasonal flu, which infects 100% of ferrets via respiratory droplets,” the CDC said. “These findings are not surprising and do not change CDC’s risk assessment for most people, which is low.” CIDRAP
SURVEILLANCE + DETECTION
Application of the Modified Grunow-Finke Risk Assessment Tool to the Sverdlovsk Anthrax Outbreak of 1979
The modified Grunow-Finke tool (mGFT) is an improved scoring system for distinguishing unnatural outbreaks from natural ones. The 1979 Sverdlovsk anthrax outbreak was due to the inhalation of anthrax spores from a military laboratory, confirmed by Russian President Boris Yeltsin in 1992. At the time the Soviet Union insisted that the outbreak was caused by meat contaminated by diseased animals. At the time there was no available risk assessment tool capable of thoroughly examine the origin of the outbreak. This study aimed to retrospectively apply the mGFT to test its ability to correctly identify the origin of the Sverdlovsk anthrax outbreak of 1979 as unnatural, using data available up to 1992, before the disclosure of a laboratory leak. Military Medicine
Rapid Detection of Ebolavirus Using Isothermal Recombinase-Aided Amplification
A fast and field-deployable molecular detection method, such as the isothermal amplification recombinase-aided amplification (RAA), could significantly reduce sample-to-result time. Here a rapid isothermal RT-RAA assay was evaluated, detecting down to 22.6 molecular copies per microliter. Testing 40 archived samples yielded clinical sensitivity and specificity of 100% each. Journal of Medical Virology
SARS-CoV-2 Detection and Genomic Surveillance: Moving to Ensure Accessible Tools in Low-Income And Middle-Income Countries
At the beginning of the COVID-19 pandemic, most LMICs faced serious challenges owing to the absence of reagents and supplies (such as RNA extraction kits, RT-qPCR kits, and oligos) for SARS-CoV-2 detection using RT-qPCR. Similar challenges were encountered in genomic sequencing. What does the scientific community need to do to improve access to diagnostic tools and genomic surveillance in LMICs? The Lancet Microbe
Detection of Novel Influenza Viruses Through Community and Healthcare Testing: Implications for Surveillance Efforts in the United States
In a baseline scenario reflecting the presence of 100 novel virus infections with similar severity to seasonal influenza viruses, the median probability of detecting at least one infection per month was highest in urgent care settings (72%) and when community testing was conducted at random among the general population (77%). However, urgent care testing was over 15 times more efficient (estimated as the number of cases detected per 100,000 tests) due to the larger number of tests required for community testing. In scenarios that assumed increased clinical severity of novel virus infection, median detection probabilities increased across all healthcare settings, particularly in hospitals and ICUs (up to 100%) where testing also became more efficient. Influenza and Other Respiratory Viruses
ANTIMICROBIAL RESISTANCE CRISIS
Implementing an EU Pull Incentive for Antimicrobial Innovation and Access: Blueprint for Action
Key considerations to support the implementation of the new pull incentive— the size of the potential pull incentive and possible contributions of the member states, design of the incentive model, interplay of the new pull incentive with the proposed revisions of the EU pharmaceutical legislation, roles and responsibilities of both the EU and member states, balance between pull and push incentives, and global cooperation and responsibility. The Lancet Microbe
Understanding the Evolutionary Potential of mcr-1: Growing Evidence on Costless Colistin Resistance
Colistin is a last-resort antibiotic against multidrug resistant Gram-negative bacteria of high clinical relevance. The historical and current use of colistin as feed additive for promoting livestock and poultry growth and in veterinary applications has favored the emergence and spread of mobilized colistin resistance (mcr) genes 1 to 10, posing a substantial threat to public health. Among these, mcr-1, discovered in 2015, is particularly concerning due to its wide dissemination in agricultural, environmental, and clinical settings. The Lancet Microbe
COVID-19 PANDEMIC
AZD2816 and AZD1222 (ChAdOx1 nCoV-19) as Primary-Series Vaccination for Previously Unvaccinated Adults
AZD2816 is a variant-adapted COVID-19 vaccine that expresses the full-length SARS-CoV-2 beta variant spike protein but is otherwise similar to AZD1222 (ChAdOx1 nCoV-19). This study evaluated the safety and immunogenicity of AZD1222 or AZD2816 (or both) primary-series vaccination in a cohort of adult participants who were previously unvaccinated. The Lancet Microbe
Paxlovid Did Not Beat Placebo in Stanford-Led Long Covid Study
Pfizer’s Covid-19 antiviral did not improve symptoms in patients with long Covid compared to placebo — the latest disappointment for patients with the post-infection condition. BioSpace, Endpoints
Identifying Veterans Who Benefit From Nirmatrelvir-Ritonavir: A Target Trial Emulation
Nirmatrelvir-ritonavir is recommended for persons at risk for severe coronavirus disease 2019 (COVID-19) but remains underutilized. This target trial emulation study in the Veterans Health Administration compared nirmatrelvir–ritonavir treated vs. matched untreated veterans at risk for severe COVID-19 who tested positive over approximately a 1 year period. Nirmatrelvir-ritonavir was effective in reducing 30-day hospitalization and death in older veterans, those at highest predicted risk for severe outcomes, and immunocompromised groups. Benefit was not observed in younger veterans or groups at lower predicted risk for hospitalization and death. Clinical Infectious Diseases
Development of Next-Generation COVID-19 Vaccines: BARDA Supported Phase 2b Study Designs
Next-generation vaccine platforms with a new mechanism of action may necessitate efficacy trials to fulfill regulatory requirements. The Biomedical Advanced Research and Development Authority (BARDA) will be supporting Phase 2b clinical trials of candidate next-generation vaccines. The primary endpoint will be improved efficacy in terms of symptomatic disease relative to a currently approved COVID-19 vaccine. In this paper, we discuss the planned endpoints and potential challenges to this complex program. Clinical Infectious Diseases
HISTORICAL REFLECTIONS
Jenner: An Inquiry Into the Causes and Effects of the Variolae Vaccinae
First published in 1798, this updated edition of Jenner’s treatise on the use of cowpox to vaccinate against smallpox contains Jenner’s substantial Further observations and A continuation and facts and observations which were not present in the first edition but had been issued separately in 1799 and 1800 to provide more evidence for his findings and to counter objections and criticisms of his research. Sotheby’s
SPECIAL INTEREST
USDA-ARS Strategic Safety Climate Management Initiatives Fellowship
A research opportunity is currently available with the USDA Agricultural Research Service (ARS), National Bio and Agro-Defense Facility (NBAF), located in Manhattan, Kansas. ORAU
ALSO READING
Characterization of two genotype I African Swine Fever Viruses from Sardinian wild boars. Veterinary Research
The role of healthcare epidemiologists in communicating during infectious diseases outbreaks. ICHE
How preventable hospitalizations became a widely used but flawed quality measure. Health Affairs
The need for historical fluency in pandemic law and policy. Journal of the History of Medicine and Allied Sciences
Estimating country-level spending on pandemic preparedness. Journal of Global Health
The Diverse Genomes of Candida auris. The Lancet Microbe
Bacteriophage-based bioassays: an expected paradigm shift in microbial diagnostics. Future Microbiology
Successful Distribution of Tecovirimat During the Peak of the Mpox Outbreak — Los Angeles County, June 2022–January 2023. MMWR
Emerging infectious disease prevention: Veterinary action required. Australian Veterinary Journal