This week’s topics include the upcoming Biological Weapons Convention Meeting of States Parties, the latest H5N1 news, impact of Trump Administration nominees for key biomedical positions, and the global rise of measles cases.
FEATURED
Bird Flu: Canadian Teenager Still Critically Ill with New Genotype
A Canadian adolescent with no underlying conditions is in stable but critical condition, unable to breathe independently, in a British Columbia hospital after becoming infected with a new genotype of H5N1 highly pathogenic avian influenza. The patient, who has not been publicly identified, developed conjunctivitis on 2 November, followed by fever and coughing. While these symptoms have been common in people infected with H5N1 bird flu in North America—until now, all US cases—the teenager in Canada then developed acute respiratory distress syndrome and was admitted to intensive care on 8 November. The diagnosis of avian flu was confirmed, and the genotype identified, on 13 November. The BMJ, Nature, STAT, The Guardian, CBC
CDC Confirms H5N1 Bird Flu Infection in a Child in California
This is the first reported avian influenza H5 virus infection in a child in the United States. Consistent with previously identified human cases in the United States, the child reportedly experienced mild symptoms and received flu antivirals. There were low levels of viral material detected in the initial specimen collected, and follow-up testing of the child several days later was negative for H5 bird flu but was positive for other common respiratory viruses. The source of infection is not known — although health officials are looking into possible contact with wild birds. CDC, IDSE, Los Angeles Times, CalMatters
The 2024 Meeting of States Parties to the BWC will Convene 16-18 December
Select side events at the upcoming meeting include: Lessons from the Regional Workshop on Implementing the BWC and Promoting Biosafety and Biosecurity in SE Asia; DNA Synthesis Screening and the BWC; Strategic Challenges and AI; and The BWC & WMD Free Zone in the Middle East. UN Office for Disarmament Affairs
Measles Cases Rise 20% Worldwide in 2023, Per New Report
In 2023, 10.3 million cases of measles were reported globally, with increases occurring in most regions of the world. Despite the double-digit increase in the number of cases, 107,500 deaths from measles were reported, down 8% from 2022. That is likely due to the geographic distribution of the cases, with children in low-income countries or conflict zones more likely to die from measles infections. STAT
POLICY + GOVERNMENT
The International Bioweapons Regime Must Be Strengthened, Not Exploited in Geopolitical Competition
Since Russia’s invasion of Ukraine in 2022, biological weapons have become a trope in the war of narratives between Moscow and Washington. The North Atlantic Treaty Organization’s new biotechnology strategy explicitly singles out Russia as a bad actor. International cooperation, not blocs, is required to confront the emerging problems of biosecurity, from genetic modification to enhanced pathogens of pandemic potential. Nanyang Technological University, Singapore
Possible Models of BWC Verification
This briefing serves as a primer for consideration of possible models of verification. Past discussions of verification in the BWC have largely focused on the development of a more traditional disarmament verification regime, akin to the model established in the Chemical Weapons Convention (CWC) and envisaged in the BWC Protocol Negotiations. Such a model is often considered the standard model for verification and could provide greater confidence in compliance with the BWC. However, the traditional model of verification is not the only model available to BWC States Parties. UNIDIR
BWC at 50: Taking Bold Steps to Secure the Future
This coming year marks 50 years of the Biological Weapons Convention (BWC) and a pivotal moment to assess its impact and where we go from here. The BWC faces significant challenges and there is an urgent need to modernize the BWC, ensuring it keeps pace with scientific developments and reinforces global biosecurity. NTI
Deterrence Without Destruction: Rethinking Responses to Biological Threats
Deliberate biological threats are harder to attribute than nuclear attacks, creating a vastly different landscape for deterrence efforts. An expansion of nuclear deterrence to include biological threats is undesirable because it could further erode the taboo against nuclear use. Nuclear weapons pose problems beyond the big question of strategic stability between great powers. For example, the Russian war of aggression against Ukraine has woken up the West to the danger of nuclear blackmail. To strengthen norms around responsible use of nuclear weapons and promote restraint, the West should not turn to the same tactic to deter biological weapons. European Leadership Network
Confidence in Disarmament: Some Insights from the Treaties Banning Biological and Chemical Weapons
“While we aspire to have the best verification tools to have confidence in compliance with disarmament and arms control treaties, the potential for exploiting the provisions, procedures and institutions of the treaties through lawfare to spread disinformation and undermine confidence in the functioning of these treaties is a current and challenging battle to fight.” The Trench
Trump Picks Stanford Doctor Who Opposed Lockdowns to Head N.I.H.
If confirmed by the Senate, Dr. Jay Bhattacharya would lead the world’s premier medical research agency, with a $48 billion budget and 27 separate institutes and centers. Dr. Bhattacharya, who is not a practicing physician, has called for overhauling the N.I.H. and limiting the power of civil servants who, he believes, played too prominent a role in shaping federal policy during the pandemic. Dr. Bhattacharya is one of three lead authors of the Great Barrington Declaration, a manifesto issued in 2020 that contended that the COVID-19 virus should be allowed to spread among young healthy people who were “at minimal risk of death” and could thus develop natural immunity, while prevention efforts were targeted to older people and the vulnerable. New York Times
Republicans Ask GAO to Assess Structure of CDC, FDA, and NIH Lab Safety Offices
Republicans on the House Energy and Commerce Committee sent a letter to the Government Accountability requesting an examination of the structure of laboratory safety programs at the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the National Institutes of Health (NIH). “This committee remains concerned about the effectiveness of the oversight HHS and its agencies provide to the laboratories they own and operate. In addition to numerous GAO recommendations that remain unimplemented by the FDA, both the CDC and the FDA recently announced organizational reforms to their laboratory safety and security functions, and it is not clear whether these changes will strengthen oversight or create new undue risk.” House Energy and Commerce Committee
The Appointment of Robert F Kennedy Has Horrified Public Health Experts. Here are His Most Dangerous Ideas
Kennedy is well known as a prominent anti-vaxxer. He has claimed that vaccines can cause autism, and also said that “there’s no vaccine that is safe and effective”. He called the Covid-19 vaccine the “deadliest vaccine ever made”. The big question is how much harm he can do in the next few years as the man who oversees health agencies in the US. Will he roll back budgetary allocations for vaccination campaigns? Eliminate research into new vaccines? With avian flu continuing to spread in mammals and birds, will he support the stockpiling and rollout of H5N1 vaccines if necessary in a future outbreak or pandemic? The Guardian, STAT
How RFK Has Worked Abroad to Weaken Global Public Health Policy
Mr. Kennedy, an environmental lawyer, has spent years working abroad to undermine policies that have been pillars of global health policy for a half-century, records show. He has done this by lending his celebrity, and the name of his nonprofit group, Children’s Health Defense, to a network of overseas chapters that sow distrust in vaccine safety and spread misinformation far and wide. New York Times
MEDICAL COUNTERMEASURES
Ebola: Can a Vaccine Drive Stop History from Repeating Itself?
Sierra Leone will this week become the first country to launch a nationwide preventive Ebola vaccination campaign for people at the highest risk. Over three weeks, officials aim to deliver 20,000 doses of Merck’s Ervebo vaccine in a drive that will be repeated every two or three years. The Guardian
Mpox Vaccine Appears Safe for Use in Adolescents
The modified vaccinia Ankara-Bavarian Nordic (MVA-BN) vaccine is approved in several countries for use in the prevention of mpox and smallpox in adults. New research suggests it’s also safe and produces an immune response in adolescents, a population affected by the current clade I mpox outbreak. These results could support a broader application of the MVA-BN vaccine, but the authors stressed the need to review the vaccine’s effectiveness in children younger than 12 years, who are also affected by the current global outbreak. JAMA
Estimated Effectiveness of Influenza Vaccines in Preventing Secondary Infections in Households
Influenza vaccine effectiveness (VE) is commonly assessed against prevention of illness that requires medical attention. Few studies have evaluated VE against secondary influenza infections. In this cohort study of 699 primary cases and 1581 household contacts, the secondary infection risk of influenza infection among household contacts was 18.8%. The estimated effectiveness of influenza vaccines for preventing secondary infections among household contacts was 21%. Influenza vaccination was associated with a reduced risk of laboratory-confirmed influenza virus infection among household contacts. JAMA Network Open
BIOSECURITY + BIOPREPAREDNESS
Handling Animals in ABSL-3 Labs During a Storm
Hurricanes and severe weather can pose significant risks to both the animals and the personnel responsible for their care. Proper planning and clear protocols are essential to minimize these risks and protect the integrity of ongoing research. World BioHazTec
Psychological First Aid During Ebola Virus Disease Outbreaks
This manual is designed to orient helpers to offer psychological first aid (PFA) to people affected by an Ebola outbreak. PFA involves humane, supportive and practical assistance for people who are distressed, in ways that respect their dignity, culture and abilities. This document was provisionally made available in 2014 and this updated 2024 version is published to ensure that all facts on Ebola virus disease (EVD) are in line with the latest evidence. World Health Organization
A Bird Flu Pandemic Would Be One of the Most Foreseeable Catastrophes in History
The H5N1 avian flu, having mutated its way across species, is raging out of control among the nation’s cattle, infecting roughly a third of the dairy herds in California alone. Farmworkers have so far avoided tragedy, as the virus has not yet acquired the genetic tools to spread among humans. But seasonal flu will vastly increase the chances of that outcome. As the colder weather drives us all indoors to our poorly ventilated houses and workplaces, we will be undertaking an extraordinary gamble that the nation is in no way prepared for. New York Times
Knowledge, Attitudes, And Practices Toward Bioterrorism Preparedness Among Nurses
In this study, knowledge of bioterrorism was significantly negatively correlated with attitudes and practices, which could be attributed to the specificity of bioterrorism itself. To improve nurses’ bioterrorism preparedness, continuing medical education efforts must be strengthened, as well as regular delivery of bioterrorism-specific training and drills. BMC Nursing
Preparing for Containment and Mitigation of Pandemic H5N1 Influenza, Uses of Statistical and Mathematical Modeling
To coordinate efforts for containment and mitigation of H5N1, and especially to evaluate the efficacy of vaccines and therapeutics, a mathematical modelling group has been created in the WHO R&D Blueprint and a virtual consultation held on 14 Nov. to describe how statistical and mathematical models can aid in dealing with this pandemic threat. View the slide presentations at the link. World Health Organization
SELECT AGENTS + PRIORITY PATHOGENS
Time Between Symptom Onset and Various Clinical Outcomes: Analysis of MERS-CoV Patients in Saudi Arabia
Timely diagnosis of MERS-CoV poses a significant obstacle for global healthcare systems, leading to transmission clusters within both communities and healthcare settings. This article estimates the time periods between symptom onset in MERS-CoV cases and key clinical outcomes, such as hospitalization, confirmation, reporting and death. Despite a high level of clinical suspicion surrounding MERS-CoV cases, many patients experience delays in obtaining a diagnosis and seeking prompt medical attention. Royal Society Open Science
CDC Lifts Level 3 Travel Advisory for Marburg in Rwanda
The level 3 notice recommend that people reconsider nonessential travel due to Rwanda due its Marburg outbreak. On November 22 the US Centers for Disease Control (CDC) downgraded the advisory to level 2, which recommends taking enhanced precautions. CIDRAP
Ophthalmic Sequelae of Ebola Virus Disease in Survivors
This retrospective observational study included a large cohort of 521 EVD survivors who underwent comprehensive ophthalmic examination at long-term follow-up, ≈3.5 years after their initial admission for acute EVD. Nearly 20% of EVD survivors in this cohort had moderate vision impairment of 20/50 or worse in their better-seeing eye, which indicated ongoing ophthalmic disease at long-term follow-up. The most common ophthalmic findings were cataracts (11.2%), uveitis (8.3%), dry eyes (7.8%), and chorioretinal scar. EVD survivors with cataracts, uveitis, optic neuropathy, and corneal scar were more likely to have vision impairment. Emerging Infectious Diseases
Nipah Virus Research Priorities: Who Sets Them and For Whom?
The WHO’s Nipah roadmap risks prioritizing donor-driven goals, such as regulatory approvals of medical countermeasures by 2028, over immediate regional needs, echoing the 2014–16 Ebola response, which favored costly interventions over essential disease control strategies. The paucity of meaningful stakeholder and community engagement during the 2014–16 Ebola epidemic sidelined local expertise, and the focus on high-cost, technologically advanced solutions often led to products that many communities could not access or afford. The Lancet Infectious Diseases
Lack of Lloviu Virus Disease Development in Ferret Mode
Lloviu virus is a member of the Filoviridae viral family, a family which contains several human pathogens such as ebolaviruses and Marburg virus. The first isolate of the emerging filovirus Lloviu virus (LLOV) was obtained in 2022. No animal disease models have been established. Here researchers assessed the pathogenic potential of LLOV in ferrets after intranasal, intramuscular, or aerosol exposure. The lack of disease development shows ferrets are not a disease model for LLOV. Emerging Infectious Diseases
MPOX
Second Meeting of the International Health Regulations Emergency Committee Regarding the Upsurge of Mpox 2024
Notwithstanding some progress towards controlling the spread of mpox resulting from national and international response efforts, the Committee noted the rising number and continuing geographic spread of mpox cases, especially those due to monkeypox virus clade Ib infection; the operational challenges in the field in need of stronger national commitments; as well as the need to mount and sustain a cohesive response across countries and partners. The Committee advised that the event continues to meet the criteria of a public health emergency of international concern (PHEIC). Read more on the proceedings and recommendations at the link. World Health Organization
WHO Adds LC16m8 Mpox Vaccine to Emergency Use Listing
This is the second mpox vaccine to be supported by WHO following the Director-General’s declaration of an mpox a PHEIC on 14 August 2024. World Health Organization
WHO Says Mpox Cases in Congo’s Epicenter Where the New Variant Was Detected May be ‘Plateauing’
Cases of mpox in the region of Congo where a new and more infectious variant was first detected appear to be “plateauing,” the World Health Organization said on Monday, even as the virus continues to increase in other areas of the country, as well as in Burundi and Uganda. AP
First Case of Clade I Mpox Diagnosed in the United States
On 16 Nov, the California Department of Public Health (CDPH) confirmed the first reported case of clade I mpox in the United States. This individual had recently traveled to areas experiencing clade I monkeypox virus (MPXV) transmission and sought medical care for mpox symptoms in the United States. Consistent with other recent clade I mpox cases, the patient has relatively mild illness and is recovering. CDC and the local and state health departments are investigating potential contacts; no additional cases in the U.S. have been detected as of November 18, 2024. The risk of clade I mpox to the public in the United States remains low. CDC Health Alert Network, California Department of Public Health
Public Health Agency of Canada Confirms the First Case of Clade I Mpox in Canada
On 22 Nov, PHAC confirmed the first case of clade I mpox in Canada in an individual in Manitoba. The individual sought medical care for mpox symptoms in Canada shortly after returning from overseas travel and is currently isolating. A public health investigation, including contact tracing, is ongoing. Government of Canada
AVIAN INFLUENZA
The World Is Watching the U.S. Deal With Bird Flu, and It’s Scary
The pathogen poses a serious pandemic threat and has been detected in over 500 dairy herds in 15 states — which is probably an undercount. And yet the U.S. response appears inadequate and slow, with too few genomic sequences of H5N1 cases in farm animals made publicly available for scientific review. “I know how flabbergasted many American scientists are about the country’s slow response to the H5N1.” New York Times
Epidemiological Data of an Influenza A/H5N1 Outbreak In Elephant Seals in Argentina Indicates Mammal-to-Mammal Transmission
Genomic analysis shows that viruses from pinnipeds and terns in Argentina form a distinct clade with marine mammal viruses from Peru, Chile, Brazil and Uruguay. Additionally, these marine mammal clade viruses share an identical set of mammalian adaptation mutations which were also present in tern viruses. Our combined ecological and phylogenetic data support mammal-to-mammal transmission and occasional mammal-to-bird spillover and suggest multinational transmission of H5N1 viruses in mammals. Nature Communications
CDC A(H5N1) Bird Flu Response Update
In this Nov 18 update, CDC reports a total of confirmed avian influenza A(H5) virus infections in 52 people in the United States this year. Twenty-one of these cases were associated with exposure to virus -infected poultry and 30 were associated with exposure to infected dairy cows. The source of the exposure in one case, which was reported by Missouri on September 6, could not be determined. CDC is aware of the human case of H5N1 bird flu reported in Canada and is in communication with the Public Health Agency of Canada (PHAC), which has confirmed that the case was caused by an H5N1 virus that is different than those causing outbreaks in dairy cows and other animals in the United States. CDC
California Reports Avian Flu in Retail Raw Milk Sample
The California Department of Public Health (CDPH) this week announced that sampling of retail raw milk for avian flu turned up a positive sample, based on testing at the Santa Clara Public Health Laboratory, with results confirmed the state’s food safety lab. Milk from infected cows contains extremely high levels of the H5N1 virus. Pasteurization inactivates the virus. CIDRAP
Immune History Shapes Human Antibody Responses to H5N1 Influenza Viruses
Previous studies suggest that older humans are more resistant to H5N1 infections due to childhood imprinting with other group 1 viruses (H1N1 and H2N2); however, the immunological basis for this is incompletely understood. Here researchers show that antibody titers to historical and recent H5N1 strains are highest in older individuals and correlate more strongly with year of birth than with age, consistent with immune imprinting. NIH (pre-print)
Potential Research Priorities to Inform U.S. Readiness and Response to Avian Influenza A (H5N1): Proceedings of a Workshop
The National Academies hosted a public workshop in October 2024 to explore potential research priorities that could inform readiness and response to the outbreak. This brief summarizes key points raised by workshop participants and covers topics related to transmission dynamics, surveillance, mitigating risk to animal and human health, and cross-cutting issues, such as incentives, community engagement, and research capacity. National Academies
Avian Flu Detected on Oahu for the First Time Ever
For the first time ever, Hawaii’s Department of Health believes they’ve detected H5 Avian influenza from a wastewater site on Oahu. DOH says Hawaii has been the only state without H5N1 detected in birds or animals and there are no reports of human or animal H5N1 cases in Hawaii. Hawaii News Now
Increase in Antibody Titers from H5N1 Vaccine Confers Cross-Protection Against Highly Pathogenic H5N1 Influenza Virus
The findings of this study suggest that with increased antibody titers, China’s H5N1 vaccine is capable of generating cross neutralizing antibodies against H5N1 strains. Until new H5N1 vaccines are developed, measures such as using a more efficacious adjuvant, increasing the number of doses, or adjusting the dosage could enhance antibody titers, enabling this vaccine to function as a bridging measure to prevent further outbreaks of HPAI. SSRN
CHEMICAL + RADIOLOGICAL THREATS
Reviving Chemical Weapons Accountability in a Multipolar World
The norm against chemical weapons use has come under increased strain in the past decade. The Technical Secretariat of the OPCW last week issued a report concluding that it had found a riot control agent (RCA) in the trenches in Ukraine. The report is the latest chink in the armor of the Chemical Weapons Convention, which prohibits the development, stockpiling, and usage of chemical weapons. CSIS
Chief Medical Officer Had Nightmares After Spy Novichok Poisoning
The former chief medical officer for England said she had experienced nightmares about someone picking up discarded nerve agent after the poisoning of a former spy. Sergei Skirpal and his daughter Yulia were poisoned by Novichok in Salisbury in March 2018. The attempted murders were followed by the death of Dawn Sturgess, 44, in July of that year, after she was exposed to the chemical weapon which was left in a discarded perfume bottle. BBC
The International Community Held Russia to Account for Not Abiding by Chemical Weapons Treaty
Meeting this week in The Hague, member countries to the Chemical Weapons Convention (CWC) treaty denied Russia a seat on the Executive Council of the Organization for the Prohibition of Chemical Weapons (OPCW), the treaty’s governing body. The move came in the wake of a Nov. 18 OPCW report that contained compelling evidence validating Ukraine’s claims that Russia is violating the accord by using riot control agents on the battlefield. RAND
Classification, Chemical, and Toxicological Properties of Carbamate Nerve Agents
Recently, carbamate nerve agents (CNAs) gained popularity after the inclusion of a small subset of carbamate agents in the Chemical Weapons Convention (CWC) list of Schedule 1 chemicals. To date, CNAs have not been used in any military conflict or chemical terrorism act. This may be related to the fact that these agents are solids and therefore more sophisticated and complicated systems are required for their dissemination. Nevertheless, CNAs could in theory be used to contaminate water or in assassination attempts in a manner that resembles the previous use of VX and A-agents. Xenobiotics
Evaluation of Emergency Nurses’ Knowledge of Medical Response in Nuclear and Radiological Emergencies
In this survey of 594 emergency nurses, the knowledge scores were highest for radiation exposure effects, followed by radiation protection measures. Scores were lowest for decontamination procedures. 97.47% of the nurses categorized as having poor knowledge level for this type of emergency. Concerning findings include emergency nurses’ misconceptions about the protection provided by dense materials, the effectiveness of increasing distance from a radiation source, and prioritizing decontamination of victims over life-saving measures. Additionally, they were unaware of the immediate symptoms following radiation exposure and misunderstood that the primary threat in a radioactive bomb event is the explosion rather than the radiation itself. BMC Nursing
Gender and Ionizing Radiation: Towards a New Research Agenda Addressing Disproportionate Harm
The mid- and long-term consequences from radiation exposure manifest differently for male and female survivors. This report provides an overview of recent research on the correlation between harm from exposure to ionizing radiation and biological sex. Additionally, it proposes questions for a future research agenda covering gender, radiation impacts and radiological protection standards. UNIDIR
Six People Are Dead After a Suspected Mass Methanol Poisoning at a Backpacker Party Town. What Went Wrong In Laos?
On Friday, the 19-year-old Australian Holly Bowles became the sixth person to die from the suspected consumption of drinks laced with methanol. News of her death came just hours after that of British lawyer Simone White, 28. Bowles’s best friend, Bianca Jones, 19, died on Thursday in hospital in Udon Thani, in Thailand, near the northern border with Laos. Thai authorities confirmed the Melbourne teenager died due to methanol poisoning. Three other tourists – two Danish citizens, 19 and 20, and an American – died in Laos after the poisoning. About 11 foreign citizens remain in hospital. The Guardian
SURVEILLANCE + DETECTION
Current Epidemic Trends for States
Snapshot resource from the CDC estimating the time-varying reproductive number, Rt —a measure that helps quickly assess whether infections are increasing or decreasing. As of 26 Nov, COVID-19 infections are growing or likely growing in 10 states, declining or likely declining in 15 states, and not changing in 22 states. Influenza infections are growing or likely growing in 33 states. View the maps of these epidemic trends at the link. CDC
A Consensus Statement on Dual Purpose Pathogen Surveillance Systems: The Always on Approach
The Always On approach incorporates pathogen surveillance for pandemic threats with infrastructure that supports routine clinical care and public health. While many countries are scaling back pathogen surveillance systems developed during the COVID-19 pandemic, there is an opportunity to sustain this as key health security infrastructure and build towards integrating this with tools that bring sequencing of pathogens closer to the point of patient care. PLOS Global Public Health
AI + CYBERBIOSECURITY
Healthcare Cybersecurity: HHS Continues to Have Challenges as Lead Agency
As the lead federal agency for the healthcare and public health critical infrastructure sector, the Department of Health and Human Services (HHS) has faced challenges in carrying out its cybersecurity responsibilities. HHS has not yet implemented all prior GAO recommendations in this area. GAO
What Will Be the Impact of AI on the Bioweapons Treaty?
The rapid emergence of AI might, for instance, undermine export controls meant to protect potentially weapons-related technologies and information, lower the barrier to weapons development, or assist in the development of new types of weapons. While AI also has positive implications for biological arms control, policy makers and researchers—internationally and nationally—must strive to understand the technology as it evolves in order to implement appropriate policies to guard against its risks. Bulletin of the Atomic Scientists
New FDA Panel Weighs in on Regulating Generative AI in Healthcare
The Digital Health Advisory Committee (DHAC) held its first meeting to offer guidance to the FDA on a slew of questions related to the development, evaluation, implementation, and continued monitoring of AI-enabled medical devices. The committee noted that the FDA should consider developing a small set of widely accepted metrics and methods to be used in the evaluation of such devices. They also pointed to a lack of sufficient study designs to test these devices for clinical use, and urged the FDA to explore potential use of alternative study approaches, such as synthetic control trials. MedPage Today
INFECTIOUS DISEASES
Why Scientists are Worried About Oropouche Virus
A little-known virus is getting a lot of attention this year. It’s called Oropouche, and it’s been making headlines because of a notable increase in diagnoses. So far in 2024 there have been over 10,000 cases, mainly in South America and the Caribbean. The vast majority are in Brazil. By contrast, the total Oropouche count in Brazil recorded between 2015 and 2022 was 261. Of the 21 recorded cases in the United States, all involved an individual who had traveled to Cuba and contracted the virus there. NPR
Any Bite From a Bat is a Potential Rabies Exposure
A woman from California recently died of rabies. She was a teacher who found a bat in her classroom which she handled while trying to carefully remove it, and she was bitten in the process. It was a minor bite, which makes it easy to dismiss because of the limited amount of trauma. But that tiny bite can transfer enough rabies virus to a person to cause infection. Worms and Germs
Underutilization of Influenza Antiviral Treatment Among Children and Adolescents at Higher Risk
Data from two national influenza surveillance networks indicate that antiviral treatment of hospitalized children and adolescents with influenza has declined from 70%– 86% during the 2017–18 season to <60% in 2023–24. Only 30% of children and adolescents at higher risk for influenza complications were prescribed antivirals during outpatient visits. MMWR
Why Whooping Cough Cases Are Spiking Across the U.S.
Whooping cough cases are up sixfold from the same time last year in the U.S. Experts say the spike in cases is likely a return to the pre-pandemic cycle, in which cases of the illness would ebb and flow about every five years. But, some experts worry that a decline in vaccine uptake in the past several years could set this season to be more severe. This year, the CDC has recorded around 25,000 cases of pertussis, according to its most recent data. STAT
Asylum Seekers at Risk for Measles, Hepatitis, Other Vaccine-Preventable Diseases
A research letter yesterday in the New England Journal of Medicine describes the serostatus (the presence of absence of antibodies in the blood) of asylum seekers in the United States and shows that substantial proportions are susceptible to vaccine-preventable infections such as measles, hepatitis A, and varicella (chickenpox). Most asylum seekers live in congregate, temporary housing, where outbreaks of contagious diseases are frequent. “In contrast to most other immigrants in the United States, asylum seekers are not required to undergo predeparture or postarrival evaluations to screen for active infections, nor are they systematically offered immunizations against vaccine-preventable infections.” CIDRAP
Monoclonal Antibodies to Treat Diphtheria
Diphtheria, predominately a disease of children, has declined dramatically in wealthier countries over the past 80 years, but it remains important in many parts of the tropics, and there have been resurgences of the disease in some countries related to disruption in vaccine distribution. Here researchers describe a first-in-human, randomized, double-blind, dose-escalation study of S315, a fully human, monoclonal immunoglobulin G1 neutralizing antibody, specific to the receptor-binding domain of diphtheria toxin. The promising early data gives hope that commercially produced monoclonal antibodies could provide a reliable alternative to equine antiserum for the treatment of diphtheria. The Journal of Infectious Diseases
INFODEMIC + DISINFORMATION
Covid Denier Who Posted Violent Threats Against Chris Whitty Jailed for Five Years
The trial previously heard that the defendant had targeted individuals including the UK government’s chief medical officer and the chief executive officer of Covid vaccine developer Pfizer in a series of posts during 2021. Social media posts spanned months and encouraged serious violence and disruption designed to influence the government or intimidate a section of the public. They reached a “very large audience” through two Telegram chat groups. The Guardian
Idaho Health Agency Halts COVID Vaccine Program, Joining Backlash
A health department in Idaho has voted to halt its COVID-19 vaccination program, joining the growing number of regional governments pushing back against federal vaccination recommendations. Board members at Southwest District Health, outside of Boise, questioned the vaccine’s safety during their Oct. 22 meeting and narrowly voted to stop providing the shot in the six counties they serve. Health departments in Texas, Florida and Michigan that led vaccination campaigns in their communities at the height of the pandemic have also pushed back against the COVID-19 vaccine. Last year, Texas policymakers banned health departments and other organizations funded by the state government from using funds to promote their vaccination efforts. USA Today
ANTIMICROBIAL RESISTANCE CRISIS
Should All Hospitalized Patients Colonized with Candida Auris Be Considered for Isolation?
Candida auris is an emerging pathogenic yeast causing nosocomial infections coupled with high mortality primarily in fragile people. It is considered a serious global health threat and classified as critical fungal pathogen by the W.H.O. Well-known for its capacity to spread within healthcare settings, C. auris has often led to outbreaks that are challenging to contain. Standard cleaning protocols typically used for bacterial MDROs have proven inadequate for eradicating C. auris from the healthcare environment. Its combined properties, such as biofilm formation and salt- and thermotolerance, facilitate prolonged patient colonisation and survival outside the host. Eurosurveillance
Fears for Spread of Malaria in Africa as Study Finds Resistance to Frontline Drug
Researchers have found troubling evidence for the first time that a lifesaving malaria drug is becoming less effective in young African children with serious infections. A study of children being treated in hospital for malaria in Uganda, found signs of resistance to artemisinin in one patient in 10. A further 10 of the children studied, who were thought to have been cured of infection, suffered a repeat attack from the same strain of malaria within a month. The Guardian, NPR
Modern Warfare Is Breeding Deadly Superbugs. Why?
Nations of the Middle East, like Iraq, Syria, Yemen and Afghanistan, now suffer from particularly high rates of multidrug-resistant pathogens, and some of the world’s most fearsome superbugs have incubated in the region — Klebsiella pneumoniae, Pseudomonas aeruginosa, E. coli, MRSA and perhaps most notably A. baumannii, a strain of Acinetobacter that traveled home with U.S. soldiers. New York Times Magazine
Conference Report of the 2024 Antimicrobial Resistance Meeting
The conference highlighted the challenges in quantifying AMR and the importance of working backwards from the goal of reducing the burden of AMR. Read the summary of research presented at the link. NPJ Antimicrobials and Resistance
COVID-19 PANDEMIC
Reduced Cross-Protective Potential of Omicron Compared to Ancestral SARS-CoV-2 Spike Vaccines Against Potentially Zoonotic Coronaviruses
Compared to vaccines based on the SARS-CoV-2 Reference strain, vaccines based on Omicron spike sequences induced drastically less broadly cross-protective neutralizing antibodies against other hACE2-binding sarbecoviruses. This observation remained true whether the vaccination regimens were based on protein subunit or mRNA / LNP vaccines. The ability to quickly deploy a stockpile of Reference SARS-CoV-2 vaccines may prove effective in the event of another outbreak caused by a zoonotic transmission event involving an ACE2-binding coronavirus. The same may be true for other coronaviruses, such as those of the SARS-CoV-1 and MERS-CoV families. NPJ Viruses
HISTORICAL REFLECTIONS
Bacteriologic and Genomic Investigation of Bacillus anthracis Isolated from World War II Lab Site in China
Records suggest Bacillus anthracis was used in biowarfare during World War II, but evidence remains limited. Here researchers isolated B. anthracis from soil at the remains of a World War II–era laboratory in China. Phenotypic and genomic analyses confirmed the finding, highlighting the value of microbial forensics in biothreat investigation. The study further offers a model approach for investigating sites of historical biologic agent research related to biowarfare activities. Emerging Infectious Diseases
John Cross, Epidemic Theory, and Mathematically Modeling the Norwich Smallpox Epidemic of 1819
This paper reintroduces Dr. John Cross’ neglected and unusually complete historical data set describing a smallpox epidemic occurring in Norwich, England in 1819. PLOS One
Historical Plague Pandemics: Perspectives From Ancient DNA
The analysis of genomic diversity in ancient Y. pestis genomes has been important for better understanding patterns of evolution across past pandemic lineages. However, significant challenges exist regarding the computational reconstruction of such genomes from archaeological samples. Trends in Microbiology
Historical Assessment and Mapping of Human Plague, Kazakhstan, 1926–2003
In the late 19th and early 20th Centuries, outbreaks of plague among the population of western Kazakhstan became more frequent and larger. In this study, researchers used historical data on plague recorded in Kazakhstan to describe the epidemiology and spatial characteristics of human plague cases during 1926–2003. Emerging Infectious Diseases
SPECIAL INTEREST
Fight or Flight — Facing the Marburg Outbreak in Rwanda
“As I contemplated the constellation of persistent fevers despite antibiotics, a negative panculture, a negative malaria smear, involvement of the liver and kidneys, active bleeding at the peripheral catheter injection site, sudden seizures, increasing hypoxia and respiratory failure, and active bleeding noted during intubation, I became convinced that a viral hemorrhagic fever (VHF) in its terminal stage was the best explanation. I decided the first priority was to limit casualties, and I began to fear for the lives of the nurses and residents surrounding me.” New England Journal of Medicine
APHL Honors Laboratory Response Network for Biological Threats Preparedness Award Winners
At the 2024 Laboratory Response Network for Biological Threats Preparedness (LRN-B) Technical Meeting 13-15 Nov, the APHL and the CDC presented awards to laboratories and public health leaders who have made significant achievements in the field of biological threat agent testing. Read about the awardees at the link. American Public Health Association
Women in Science – Emerging, Major and Neglected Tropical Diseases
UNESCO’s Institute for Statistics estimates (only) 33.3% of researchers worldwide are women. While women outnumber male graduates at the university level, men continue to exceed women in most science, technology, engineering, and mathematics (STEM) careers and leadership positions (3, 4). Compared with their male colleagues, women have fewer first-author publications, receive less professional recognition, and are less likely to have research mentorship (5–8). Additionally, female researchers receive fewer grant opportunities and promotions compared with men. Harassment, assault, and marginalization sometimes truncate the careers of promising health scientists, especially those whose race, ethnicity, disability, or sexual orientation make them targets of discrimination. Frontiers in Tropical Diseases
ALSO READING
Cryo-EM structure of single-layered nucleoprotein-RNA complex from Marburg virus. Nature Communications
Risk factors for human contact with bats in Northern Tanzania. Zoonotic Diseases
Unveiling bat-borne viruses: a comprehensive classification and analysis of virome evolution. Microbiome
H5N1 from an infected dairy worker sheds light on viral transmission. Nature Medicine
Virological and clinical outcomes of influenza outpatients treated with baloxavir, oseltamivir, or laninamivir. Influenza and Other Respiratory Viruses
Dual receptor-binding, infectivity, and transmissibility of an emerging H2N2 low pathogenicity avian influenza virus. Nature Communications
Drug safety: FDA should implement strategies to retain its inspection workforce. GAO
Multiple genotypes and reassortants of severe fever with thrombocytopenia syndrome virus co-circulating in Hangzhou in Southeastern China, 2013–2023. Journal of Medical Virology
Hybrid capture-based target enrichment next-generation sequencing for the identification of respiratory pathogens and resistance-associated genes in patients. Microbiology Spectrum
A century of assessment: The Collection of Biothreat Risk Assessments (COBRA). Health Security
The effect of medical face masks on inhalation risk of bacterial bioaerosols in hospital waste decontamination station. Scientific Reports
Nanotechnology’s frontier in combatting infectious and inflammatory diseases: prevention and treatment. Signal Transduction and Targeted Therapy