Biodefense Headlines – 28 November 2021

 In Threats

News highlights on health security threats and countermeasures curated by Global Biodefense

This week’s selections include everything we don’t know about Omicron; controversy over limiting the use of Covid antivirals to unvaccinated patients; surface-aerosol stability of MERS-CoV strains; and the ability of earthworms to spread prions.

POLICY + INITIATIVES

New COVID Variant Alarms Researchers, Triggers Travel Bans

South Africa’s health ministry on Nov. 25 announced the detection of a new SARS-CoV-2 variant, B.1.1.529 (Omicron) that has quickly outpaced the Delta (B1617.2) variant and has a host of mutations that might change how the virus behaves. The World Health Organization (WHO) independent expert group has designated Omicron as the fifth variant of concern. CIDRAP, Africa CDC

Medical PPE Unfit for Women on COVID-19 Frontlines 

Less than one in five female frontline health workers say protective clothing fits them properly, according to a survey from the Women in Global Health network. PPE is primarily designed for men and often fails to protect women, research has shown. Healthcare workers from non-Caucasian populations faced additional challenges with mask fit due to diverse face shapes. “Women are 90 percent of nurses and have been the vast majority of healthcare workers in patient facing roles in the pandemic. Therefore, if medical PPE is not fit for women, it is not fit for the majority of the health workforce.” SciDev.Net

WHO is Seeking a New Treaty on Handling Future Pandemics. It Could Be a Hard Sell

The World Health Organization is convening a special session of its governing body, the World Health Assembly, to start talks on a new global treaty covering pandemics. Representatives of WHO’s 194 member states will meet virtually for three days starting on Monday to consider new international rules for handling future outbreaks. NPR

Representatives Introduce ‘Cures 2.0’ Legislation to Establish New Health Agency

Reps. Diana DeGette (D-Colo.) and Fred Upton (R-Mich.) introduced legislation this week that aims to safely and efficiently modernize health care delivery. As part of this effort, the “Cures 2.0” legislation authorizes $6.5 billion to establish and fund a new federal agency to find cures and treatments for diseases such as cancer, diabetes and Alzheimer’s disease. The planned agency, the Advanced Research Projects Agency for Health (ARPA-H), would be housed within the National Institutes of Health and would be run by a small number of program managers who would each be given a high degree of autonomy to choose which high-risk, high-reward projects to pursue. Association for the Advancement of Blood & Biotherapies

Can the Biological Weapons Convention Address New Biothreats?

States parties to the BWC convened in Geneva last week, an opportunity to take stock of its implementation and prepare for next year’s review conference. There is an urgent need to update the treaty regime by reframing discussions to properly address the complexity of modern-day biothreats.  Unlike its chemical weapons counterpart, the BWC does not have a verification mechanism. The intrinsically dual-use nature of biological research means that it cannot be verified in the same way as nuclear or chemical activities. The treaty regime therefore relies on confidence-building measures (CBMs) as its primary means of assessing compliance. This reliance is increasingly challenged by rapid advances in science and technology, which outpace states’ ability to properly assess the potential risks of certain research. Chatham House

MEDICAL COUNTERMEASURES

We Know Almost Nothing About the Omicron Variant

“What we do know about the variant is this: Some of its spike-protein mutations have been seen in other variants and other lineages described earlier on in the pandemic, and have been associated with increased transmissibility and the ability of the virus to evade the immune response. What we don’t know, and what is really hard to predict, is what the combination of mutations will do together. This particular variant now appears to be outcompeting other circulating variants in South Africa—there have been these clusters of cases. That is actually what led to this variant being identified in the surveillance systems that they have in place there.” The Atlantic

‘Patience Is Crucial’: Why We Won’t Know for Weeks How Dangerous Omicron Is

Alex Sigal, an infectious disease researcher at the Africa Health Research Institute, says he received swabs with Omicron on Wednesday and has started to grow the virus. Producing enough of it to test against sera from vaccinated and recovered individuals will take a week or two, he says. Other researchers will test viruses genetically engineered to carry just the spike protein of Omicron, a process that is faster than growing the variant itself but a bit further removed from what happens in real life. A key part of this analysis is ensuring that countries are doing adequate testing of a broad sample of people. As such studies take place, it’s crucial to closely monitor any shifts in the pandemic. Science

Canada Clears Import of J&J COVID-19 Vaccine Doses Made at Emergent Plant

Health Canada announced on Nov. 24 it would allow Johnson & Johnson to import its COVID-19 vaccine made at contract manufacturer Emergent BioSolutions’ plant in the United States. The decision Canadian health regulators completed an inspection of the facility in Baltimore, Maryland, along with the European Medicines Agency and South African Health Products Regulatory Authority. Reuters

Global Emergence of SARS-Cov-2 Variants: New Foresight Needed for Improved Vaccine Efficacy

Rather than waiting for higher efficacy vaccines or newer vaccines, existing mRNA vaccines could be used in combination with vector-based vaccines in a heterologous boost regimen or as a booster dose to enhance vaccine availability in low-income and middle-income countries. Worldwide vaccination coverage will only be achieved when vaccine availability exceeds vaccine demand globally. The Lancet Infectious Diseases

Covid-19: Doctors Will Refuse to Limit Use of Antiviral Drug to Unvaccinated Patients, Say Ethicists

Leading US ethicists have warned that doctors will revolt if the drug regulator authorizes an antiviral treatment for Covid-19 for use only in people who have not been vaccinated. Pfizer has applied to the US Food and Drug Administration for emergency authorization of its new antiviral PF-07321332 (to be marketed as Paxlovid), after promising early trial results indicated that it could cut hospital admissions by 89% among recently infected adults at high risk of severe illness who were unvaccinated. But the application for the treatment of unvaccinated people only could undermine the US immunization effort, medical ethicists have warned, by rewarding people who ignored public health advice and penalizing those who heeded it. The final FDA authorization may not reflect the application, Pfizer has noted, and could yet cover vaccinated people once trial data on that population are submitted. The BMJ

BIOSECURITY + BIOPREPAREDNESS

Investigating the Origins of Novel Pathogens

The group will “urgently give a rapid assessment of where we stand with our understanding of the SARS-CoV-2 origin.” WHO wants SAGO to also examine the possibility of a laboratory accident being responsible for the emergence of SARS-CoV-2. However, Robertson thinks the focus should be on the most realistic scenario for the emergence of the virus: infected animals in markets in Wuhan, China. “WHO has to stop wasting time pandering to unsubstantiated lab leak notions”, he said. “Enough is enough on the politicization of this topic; the stakes are the future emergence of another SARS-like coronavirus, and all our efforts need to be focused on preventing this.”  The Lancet Infectious Diseases

Potential Use for Serosurveillance of Feral Swine to Map Risk for Anthrax Exposure, Texas, USA

Resistant species may help to disseminate infectious spores to new landscapes through mechanical transmission or bacterial shedding. Feral swine are known to be opportunistic omnivores that occasionally scavenge carcasses, as well as routinely root in soils for food. Researchers here present evidence that feral swine might serve as biosentinels based on comparative seroprevalence in swine from historically defined anthrax-endemic and non–anthrax-endemic regions of Texas. Emerging Infectious Diseases

SARS-Cov-2 Could Be Lurking in Animal Hidey-Holes

Even if there are no human cases of Covid in an area, ubiquitous animal reservoirs (birds, mink, deer, cats, dogs, etc.) mean that SARS-CoV-2 may still be lurking, waiting to spill back into people. The other is that exposure to the immune systems of novel hosts may drive the evolution of new and (if they then do spill back) potentially threatening viral strains. The Economist

Experimental Oronasal Transmission of Chronic Wasting Disease Agent from White-Tailed Deer to Sheep

The objective of this study was to test the oronasal susceptibility of sheep to the agent of CWD. Researchers oronasally inoculated Suffolk sheep with a relatively low-dose of brain homogenate from a CWD-positive white-tailed deer. Sixty months after inoculation, 1/7 sheep had immunoreactivity against the misfolded form of prion protein in lymphoid tissue. Results were confirmed by mouse bioassay. Emerging Infectious Diseases

Surface‒Aerosol Stability and Pathogenicity of Diverse MERS-CoV Strains

Researchers tested a broad panel of viral isolates collected from humans and camels, representing every major geographic region that has had MERS-CoV outbreaks and spanning from early to contemporary outbreaks. The results suggest that although betacoronaviruses might have similar environmental stability profiles, individual variation can influence this phenotype, underscoring the need for continual global viral surveillance. Emerging Infectious Diseases

Uptake, Retention, and Excretion of Infectious Prions by Experimentally Exposed Earthworms

Prions are proteinaceous infectious agents that can be transmitted through various components of the environment, including soil particles. We found that earthworms exposed to prion-contaminated soil can bind, retain, and excrete prions, which remain highly infectious. Our results suggest that earthworms potentially contribute to prion disease spread in the environment. Emerging Infectious Diseases

SELECT AGENTS + CBRNE THREATS

Small-Scale Chemical and Biological Production: Current Threats and Future Trajectories

There are a number of developments, such as microfluidics and automation, which make covert manufacturing of chemical and biological substances easier than in the past. Moreover, there are also a variety of specific technical advances, such as nano-encapsulation and improved dermal absorption of pharmaceuticals, that could make it easier to make or deliver chemical and biological materials as weapons. Developments in science and technology will simplify efforts by hostile actors to operate small-scale production of these materials for hostile use. RUSI

CDC Updates ERVEBO Ebola Vaccine Information Guidance

Biosafety level 4 (BSL-4) workers and Healthcare personnel working at federally designated Special Pathogens Treatment Centers involved in the care and transport of patients infected or suspected to be infected with Ebola virus (species Zaire ebolavirus) may be eligible to receive ERVEBO depending on specific circumstances of public health needs and the Ebola preparedness and response activities at such facilities. CDC

Novel Use of Capture-Recapture Methods to Estimate Completeness of Contact Tracing During an Ebola Outbreak

How many case-patients with any contacts did contact tracing miss, and how many case-patients with infected contacts did contact tracing miss? Despite its critical role in containing outbreaks, the efficacy of contact tracing, measured as the sensitivity of case detection, remains an elusive metric. These study results indicate that EVD contact tracing efforts identified almost all of case-patients with any contacts but only half of case-patients with infected contacts, suggesting that contact tracing efforts performed well at identifying contacts during the listing stage but performed poorly during the contact follow-up stage. Emerging Infectious Diseases

Natural History of Aerosol-Induced Ebola Virus Disease in Rhesus Macaques

Differences in the aerosol model, compared to intramuscular model, include an extended subclinical stage, shortened clinical stage, and general decompensated stage. In this non-human primate model, the shortened timeframe for clinical detection of the aerosol-induced disease indicates possibilities for impaired timely therapeutic administration, and characterizes early disease markers to enable countermeasure development. Viruses

Results of a 2020 Survey on Reporting Requirements and Practices for Biocontainment Laboratory Accidents

97% of surveyed biosafety officers oversee laboratories that require reporting exposure to at least some pathogens, however a majority relayed that the reports are not usually sent outside of the institution where they occurred. While 82% of these biosafety officers agreed that workers understood the importance of reporting for their own safety, 82% also agreed that a variety of disincentives prevent laboratory workers from reporting incidents, including concerns about job loss and loss of funding. Nonaccident event reporting is emphasized as beneficial to understand how reporting and risk management is done. Near-miss reporting is a critical part of hazard analysis and safety engineering. Health Security

T-2 Toxin—The Most Toxic Trichothecene Mycotoxin

Among trichothecenes, T-2 toxin is the most toxic fungal secondary metabolite produced by different Fusarium species. Moreover, T-2 is the most common cause of poisoning that results from the consumption of contaminated cereal-based food and feed reported among humans and animals. The food and feed most contaminated with T-2 toxin is made from wheat, barley, rye, oats, and maize. As it may not be possible to completely prevent the formation of T-2 in agricultural commodities, it is important to constantly monitor the level of contamination. Molecules

Reservoir Host Studies of Lloviu Virus: First Isolation, Sequencing and Serology in Schreiber’s Bats in Europe

Several novel filoviruses have been discovered with a markedly wider geographic distribution than previously described. One of these novel filoviruses, Lloviu virus (LLOV), was first identified in 2002 in Schreiber’s bats (Miniopterus schreibersii) in Spain, Portugal, and southern France. Subsequently, in 2016, LLOV was detected during the passive monitoring of bats in Hungary. Here researchers present data on the natural infection and seropositivity of Schreiber’s bats and provide novel LLOV genomic sequence information from a bat host and an arthropod parasite. bioRxiv

Francisella tularensis: A Microbial Gene Network Study

Due to the high infectivity and fatal effect on human population, F. tularensis is classified as a potential biological warfare agent. This study helps identify the pathways associated with the pathogen offensive strategies that help in invasion of host defensive systems. Computational Biology and Chemistry

Eco-Friendly Peelable Active Nanocomposite Films Designed for Biological and Chemical Warfare Agents Decontamination

In the context of imminent threats concerning biological and chemical warfare agents, the aim of this study was the development of a new method for biological and chemical decontamination, employing non-toxic, film-forming, water-based biodegradable solutions, using a nano sized reagent together with bentonite as trapping agents for the biological and chemical contaminants. Polymers

PUBLIC HEALTH

Why Don’t We Just Open the Windows?

Current guidelines tend to focus on solid bodies, such as people; surfaces, both hard and soft; equipment; and water. Air is literally nebulous. Just as cleaning was the Cinderella of infection control during the past decade or so, we must now confront the neglected, but substantive, role of air in transmitting infection. Most buildings are neither designed nor well operated from the air quality aspect, with energy conservation and thermal comfort at the top of the list of requirements. Ventilation is usually controlled by building operators and owners, not necessarily individuals, and the former are not yet mandated by law to improve ventilation in public venues. Even simple window opening invites discussion over chill, airflow, and security.  The BMJ

Let’s Talk Turkey About Salmonella Being an Adulterant

According to the CDC, it is estimated that 1.4 million cases of salmonellosis occur each year in the United States. Of those cases, 95 percent are related to foodborne causes. Approximately 220 of each 1,000 cases result in hospitalization, and 8 of every 1,000 cases result in death. About 500 to 1,000 deaths – 31 percent of all food-related deaths – are caused by Salmonella infections each year. Yet the USDA/FSIS does not consider Salmonella an adulterant. Food Safety News

SURVEILLANCE + DETECTION

New 10-minute Test Detects Covid-19 Immunity

Researchers have successfully developed a rapid point-of-care test for the detection of SARS-CoV-2 neutralizing antibodies (NAbs). This simple test, only requiring a drop of blood from a fingertip, can be performed within 10 minutes without the need for laboratory or specially trained personnel. Currently, no similar NAb tests are commercially available within Singapore or elsewhere. Further development of the test is underway for its approval by regulatory authorities and manufacturing for public use. The team that has developed the tests at SMART has also spun off a biotech startup, Thrixen, that is developing the test into a commercially ready product. MIT News

A SARS-Cov-2 Antigen Rapid Diagnostic Test for Resource Limited Settings

A SARS-CoV-2 antigen test in an inexpensive lateral flow format to generate a chromatographic result identifying the presence of the SARS-CoV-2 antigen, and thus an active infection, within a patient anterior nares swab sample. Scientific Reports

HISTORICAL REFLECTIONS

Smallpox, Inoculation, and the Revolutionary War

George Washington enacted the first medical mandate in American history. Some believed this to be a mistake, and even Washington wavered on his order initially, though he was firm in his resolve in the end. Washington declared his order to Congress that all troops must be inoculated, and he ordered that all new recruits entering Philadelphia must be inoculated upon entry. To offset the temporary loss of soldiers while they healed from the inoculation, military doctors inoculated divisions in five-day intervals. The military used private homes and churches as isolation centers to control spread of the disease. Many historians credit the medical mandate with the colonists’ victory in the Revolutionary War and the creation of the United States of America. National Park Service

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