Global & Disaster Medicine

Archive for the ‘Bioterrorism’ Category

US and South Korean intelligence agencies say North Korea has experimented with microbes including anthrax, cholera, and plague, and are thought to have had the smallpox virus since at least the mid-1990s

The Hill

CIDRAP

Express

The Koreas at Night


Soligenex, the company developing a heat-stable ricin vaccine, received an additional $2.5 million in funding from the National Institute of Allergy and Infectious Diseases (NIAID), for work on RiVax, their ricin vaccine.

Soligenix

“….RiVax® is Soligenix’s proprietary heat stable recombinant subunit vaccine developed to protect against exposure to ricin toxin. With RiVax®, Soligenix is a world leader in the area of ricin toxin vaccine research.

RiVax® contains a genetically altered version of a Ricin Toxin A (RTA) chain containing two mutations that inactivate the toxicity of the ricin molecule. A Phase 1A clinical trial was conducted with a formulation of RiVax® that did not contain an adjuvant. This trial revealed dose dependent seroconversion as well as lack of toxicity of the molecule when administered intramuscularly to human volunteers. The adjuvant-free formulation of RiVax® induced toxin neutralizing antibodies that lasted up to 127 days after the third vaccination in several individuals…..”

 

“…..About Ricin Toxin

Ricin toxin is a lethal plant-derived toxin and potential biological weapon because of its stability and high potency, and the fact it is readily extracted from by-products of castor oil production.  Ricin comes in many forms including powder, mist or pellet. Ricin can also be dissolved in water and other liquids.

The US Centers for Disease Control and Prevention estimates that the lethal dose in humans is about the size of a grain of salt.

Ricin toxin illness causes tissue necrosis and general organ failure leading to death within several days of exposure. 

Ricin is especially toxic when inhaled. Ricin works by entering cells of the body and preventing the cells from making the proteins it needs. 

Without the proteins, cells die, which is eventually harmful to the entire body.

There are currently no effective treatments for ricin poisoning.

The successful development of an effective vaccine against ricin toxin may act as a deterrent against the actual use of ricin as a biological weapon and could be used in rapid deployment scenarios in the event of a biological attack…..”


Protecting the nation from deadly pathogens, man-made or natural: More difficult under the Prez’ budget.

NY Times

“….The Office of Public Health Preparedness and Response, which tracks outbreaks of disease, would be cut by $136 million, or 9.7 percent. The National Center for Emerging and Zoonotic Infectious Diseases — a branch of the Centers for Disease Control and Prevention that fights threats like anthrax and Ebola — would be cut by $65 million, or 11 percent.

The C.D.C.’s Center for Global Health would lose $76 million, or 18 percent. Its Emergency Operations Center, which conducts real-time monitoring of outbreak responses, and its Select Agents Program, which sets regulations in lethal toxin labs and helps researchers stay ahead of bioterrorists, face unspecified cuts as well…..”


In Ready or Not? Protecting the Public from Diseases, Disasters and Bioterrorism, 26 states and Washington, D.C. scored a six or lower on 10 key indicators of public health preparedness.

TFAH

Ready or Not? examines the nation’s ability to respond to public health emergencies, tracks progress and vulnerabilities, and includes a review of state and federal public health preparedness policies. Some key findings include:

  • 26 states increased or maintained funding for public health from Fiscal Year (FY) 2014-2015 to FY 2015-2016.
  • Just 10 states vaccinated at least half of their population (ages 6 months and older) against the seasonal flu during the 2015-2016 flu season (from July 2015 to May 2016).
  • 45 states and Washington, D.C. increased the speed of DNA fingerprinting using pulsed-field gel electrophoresis (PFGE) testing for all reported cases of Shiga toxin-producing E. coli O157, a measure of a state’s ability to detect foodborne outbreaks.
  • 10 states have a formal access program or a program in progress for getting private sector healthcare staff and supplies into restricted areas during a disaster.
  • 30 states and Washington, D.C. met or exceeded the overall national average score (6.7) of the National Health Security Preparedness Index (as of 2016).
  • 32 states and Washington, D.C. received a grade of C or above in States at Risk: America’s Preparedness Report Card, a national assessment of state-level preparedness for climate change-related threats – which have an impact on human health.

In addition, the report examined trends in public health preparedness over the last 15 years, finding successes and ongoing concerns.

  • One-third of funds for health security and half of funds for healthcare system preparedness have been cut: Health emergency preparedness funding for states has been cut from $940 million in fiscal year (FY) 2002 to $660 million in FY 2016; and healthcare system preparedness funding for states has been cut by more than half since FY 2005 – down to $255 million.
  • Some major areas of accomplishment: Improved emergency operations, communication and coordination; support for the Strategic National Stockpile and the ability to distribute medicines and vaccines during crises; major upgrades in public health labs and foodborne illness detection capabilities; and improvements in legal and liability protections during emergencies.
  • Some major ongoing gaps: Lack of a coordinated, interoperable, near real-time biosurveillance system; insufficient support for research and development of new medicines, vaccines and medical equipment to keep pace with modern threats; gaps in the ability of the healthcare system to care for a mass influx of patients during a major outbreak or attack; and cuts to the public health workforce across states.

The Ready or Not? report provides a series of recommendations that address many of the major gaps in emergency health preparedness, including:

  • Requiring strong, consistent baseline public health Foundational Capabilities in regions, states and communities-so that everyone is protected.
  • Ensuring stable, sufficient health emergency preparedness funding to maintain a standing set of foundational capabilities alongside a complementary Public Health Emergency Fund which would provide immediate surge funding during an emergency.
  • Improving federal leadership before, during and after disasters – including at the White House level.
  • Recruiting and training a next generation public health workforce with expert scientific abilities to harness and use technological advances along with critical thinking and management skills to serve as the Chief Health Strategist for a community.
  • Reconsidering health system preparedness for new threats and mass outbreaks by developingstronger coalitions and partnerships among providers, hospitals, insurance providers, pharmaceutical and health equipment businesses, emergency management, and public health agencies.
  • Prioritizing efforts to address one of the most serious threats to human health by expanding efforts to stop Superbugs and antibiotic resistance.
  • Improving rates of vaccinations for children and adults – which are one of the most effective public health tools against many infectious diseases.

Ready or Not? was released annually from 2003-2012, and more recently, TFAH has released Outbreaks: Protecting Americans from Infectious Diseases, from 2013-2015.The report was supported by a grant from the Robert Wood Johnson Foundation (RWJF).

Score Summary:

A full list of all of the indicators and scores and the full report are available on TFAH’s website. For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest. The data for the indicators are from publicly available sources or were provided from public officials.

10 out of 10: Massachusetts

9 out of 10: North Carolina and Washington

8 out of 10: California, Connecticut, Iowa, New Jersey, Tennessee and Virginia

7 out of 10: Colorado, Delaware, Florida, Indiana, Maryland, Michigan, New Hampshire, New Mexico, New York, North Dakota, Oregon, Rhode Island, South Carolina, Utah and Wisconsin

6 out of 10: Arizona, Arkansas, District of Columbia, Georgia, Hawaii, Illinois, Kansas, Kentucky, Louisiana, Maine, Minnesota, Mississippi, Montana, Nebraska, Ohio, Pennsylvania, Texas and Vermont

5 out of 10: Alabama, Missouri, Oklahoma, South Dakota and West Virginia

4 out of 10 Nevada and Wyoming

3 out of 10: Alaska and Idaho


Trump & Deadly Disease

NY Times

  • “…..President Trump’s budget would cut funding for the National Institutes of Health by 18 percent.
  • It would cut the State Department and the United States Agency for International Development, a key vehicle for preventing and responding to outbreaks before they reach our shores, by 28 percent.
  • And the repeal of the Affordable Care Act would kill the billion-dollar Prevention and Public Health Fund, which provides funding for the Centers for Disease Control and Prevention to fight outbreaks of infectious disease.
  • (While the budget also calls for the creation of an emergency fund to respond to outbreaks, there is no indication that it would offset the other cuts, or where the money would come from.)
  • We are already witnessing an outbreak of influenza in birds — the H7N9 strain, in China — that could be the source for the next human pandemic. Since October, over 500 people have been infected; more than 34 percent have died. Most victims had contact with infected poultry, yet three recent clusters appear to be from person-to-person transmission. Will H7N9 mutate to become easily transmitted between humans? We don’t know. But without sufficient supplies of a vaccine, we are not prepared to stop it…….”

Emergent Biosolutions gets Health Canada approval for Botulism antitoxin

Emergent

Emergent BioSolutions Inc.  today announced that Health Canada has approved the company’s New Drug Submission (NDS) for its botulism antitoxin, BAT® [Botulism Antitoxin Heptavalent (A, B, C, D, E, F, G) – (Equine)]. BAT is indicated for the treatment of symptomatic botulism following documented or suspected exposure to botulinum neurotoxin serotypes A, B, C, D, E, F, or G in adults and pediatric patients…….

Emergent has an existing ten-year contract, executed in 2012, to supply BAT to the Canadian Department of National Defense as well as the Public Health Agency of Canada and individual provincial health authorities. In addition, Emergent has been supplying BAT to the U.S. Strategic National Stockpile as part of a $450 million contract with the Biomedical Advanced Research and Development Authority (BARDA), within the Office of the Assistant Secretary for Preparedness and Response in the U.S. Department of Health and Human Services. BAT, which was licensed by the U.S. Food and Drug Administration in 2013, is the only botulism antitoxin available in the U.S. for treating naturally occurring, non-infant botulism, and for administering to patients under emergency conditions…..”

fish


A government investigation of lab incidents involving incomplete pathogen activation at US high-containment labs since 2003 turned up 11 events that weren’t reported and identified problems with identifying and tracking such instances.

GAO

The 21 identified incidents involved a variety of pathogens and laboratories, as shown below:

 


The National Institute of Allergy and Infectious Diseases (NIAID) of NIH has exercised an option to fund animal efficacy and toxicology studies for Soligenix’s RiVax ricin vaccine as a bioterror preparedness measure

Ricin Vaccine 

CDC:  Facts about Ricin

 


The first blood test for anthrax that could show results within minutes at a doctor’s office or ER will take the final steps in development

HHS

May 9, 2016

Contact: HHS Press Office
202-690-6343
media@hhs.gov
HHS sponsors point-of-care anthrax diagnostic test
Simple, fast finger-prick blood test could aid in medical response to bioterrorism attack.

The first blood test for anthrax that could show results within minutes at a doctor’s office or emergency room will take the final steps in development with support from the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR).

Under an 18-month $2.5 million agreement with ASPR’s Biomedical Advanced Research and Development Authority (BARDA), SRI International of Menlo Park, California, will conduct studies necessary to ensure the test accurately detects anthrax infections in blood samples; the studies are needed to apply for clearance to market the device from the U.S. Food and Drug Administration. The contract can be extended for up to a total of three years and $7.8 million.

The test being developed is based partly on a similar version developed at the Centers for Disease Control and Prevention (CDC). Anthrax diagnostic tests available today require sending samples to a laboratory for analysis, with results available in days.

The test SRI is developing uses blood samples on small cartridges; after 15 minutes, the cartridge is placed in a reader, and results are displayed. This compact system fits into the palm of a hand and can be used in locations close to the patient, such as hospital emergency rooms, local health clinics, and potentially at the patient’s bedside or by first responders.

Having the results immediately available will help doctors make fast decisions about the appropriate care and treatment for patients who may have been exposed to anthrax, particularly after an anthrax bioterrorism attack. Anthrax is an acute disease caused by Bacillus anthracis bacteria, and if untreated can be deadly. The inhaled form can cause death in a matter of days.

SRI International will work with DCN Diagnostics of Carlsbad, California, and Web Industries of Holliston, Massachusetts, on regulatory, design, and manufacturing studies of the anthrax diagnostic test.

BARDA, CDC and other federal agencies coordinate as a Public Health Emergency Medical Countermeasure Enterprise (PHEMCE) to prioritize medical countermeasures – drugs, vaccines, and diagnostics – needed in public health emergencies, identify promising medical countermeasures, and transition products from early development to advanced development with the goal of FDA approval.

Protecting health after an anthrax attack requires preventing, detecting, and treating anthrax infections. To meet this national health security need, BARDA’s portfolio includes development of three anthrax antitoxin drugs that have been approved by FDA. BARDA also is supporting advanced development of vaccines to prevent illness after exposure to anthrax as well as improvements on the only vaccine licensed for use prior to exposure so that fewer doses are needed to protect health.

BARDA is seeking additional proposals for advanced development of new drugs and products to diagnose, prevent, treat, and protect health against chemical, biological, radiological or nuclear threats. Proposals are accepted through the Broad Agency Announcement BARDA-CBRN-BAA-13-100-SOL-00013, available on fbo.gov.

ASPR leads HHS in preparing the nation to respond to and recover from adverse health effects of emergencies, supporting communities’ ability to withstand adversity, strengthening health and response systems, and enhancing national health security. HHS is the principal federal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves.

To learn more about ASPR and BARDA, as well as preparedness, response and recovery from the health impacts of disasters, visit the HHS public health and medical emergency website, phe.gov and the HHS emergency medical countermeasures website, medicalcountermeasures.gov.

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NYC: Department of Homeland Security scientists are releasing (nontoxic) gases and particles on crowded subway platforms, beginning a week-long airflow study aimed at measuring the impact of a nightmarish chemical or biological terrorist attack.

New York Magazine

 

 


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