Chinese laboratory is set up in Sierra Leone to continue with Ebola and malaria research, as reported by the online news source in Sierra Leone. They will be expected to follow International Human Subject Testing guidance.

Smallpox in the drawer

     Although this happened last June 2014, about 8 months ago, it bears examining.  The CDC found smallpox in a storage room that probably dates back to 1950 when smallpox still existed in the United States.  I am told by longtime biodefense scientists that it was not unusual to put samples in drawers with the relevant file. 
Not so long ago, a museum in Richmond, Virginia discovered an old book in their collection which contained a note --- and a few other unidentifiable bits of material -- until they read the letter. The letter was written from a son to his father which read:

"Dear Pa…the piece I inclose is perfectly fresh and was taken from an infant's arm yesterday…" read the letter. "Dr. Harris says the inclosed scab will vaccinate 12 persons, but if you want more, you must send for it. I will pin this to the letter so that you cannot lose it as you did before."

     So much said with so few words. We know that there were smallpox scabs lost somewhere in addition to those folded in the paper letter sent with the intent of saving his father and others from the scourge of smallpox by giving them a slighter case with inoculation by the scab material, as was the practice. The museum thought it unique so they used it in their "bizaar bits" collection until CDC got wind of it. Reportedly,"CDC says it was just following rules. 'We really did not know what this was,' says Andrea McCollum, one of the two disease detectives who retrieved and drove the scab back to Atlanta in the trunk of their car." I find this part particularly ironic because driving with smallpox in the trunk of an individual's car is illegal and CDC violated its own regulations for transfer of select agents.  In fact, CDC was called to testify on authorizing other folk to drive around with deadly diseases in their trunk in the trial of Thomas Butler in 2004. CDC admittedly broke their own rules by recommending he drive with plague samples in his car to the CDC location in Colorado. (CDC is good at a lot of things, but self-regulation of their own activities was never a well thought-through plan.)  We should put more investment into institutional memory.
     It is really quite a miracle that we haven't had a case of smallpox since the last one in 1949 in the United States given the litter of historical memorabilia that could contain these relics.  According to a quote from Inger Damon, chief of CDC's poxvirus and rabies branch, "Over roughly the past decade, the CDC has been called to retrieve the remains of a man covered with smallpox lesions whose coffin was unearthed during construction near Louisville, Ky., as well as suspicious-looking scabs in a library book in New Mexico and a museum in Arkansas."
       Could these old scabs still be infectious today? We know some viruses are capable of waiting out a lot of harsh conditions before coming to life and infecting its target and I would not want to test it.  CDC said it probably was not dangerous as they wore biocontainment suits and handled it with mylar.
     Given these opportunities, the fact that smallpox turned up in a laboratory storage room in a government building is not all that surprising and I expect it won't be the last time.

Pham is suing the hospital for gross negligence, deception, and invasion of privacy

     The complaint alleges Texas Health Resources (hospital parent corporation) is liable for gross negligence, deception, and invasion of privacy. Pham claims they failed to provide her and the other nurses proper personal protective equipment (PPE), instructions and training in the context of a known threat of Ebola. 
     The Dallas Morning News reported that she plans to sue for damages because of the effects of the disease causing health problems that have lingered. A copy of the complaint is linked to the article.
     Typically, employees who are injured in the course of their employment must seek recovery through worker's compensation, which normally has categories of recovery in a very structured formula. But worker's compensation does not address these claims of gross negligence, deception and invasion of privacy leaving Pham free to file a complaint in the judicial system outside of the statutorily provided compensation system for employees.
      It is clear that the effects of the Ebola outbreak that came to America are not over for the victims of Ebola or for the U.S..

2,800 U.S. troops deployed to West Africa -- most will return by April 30

The Associated Press reported on Feb 11, 2015 that the President will announcement today withdrawing our deployed forces to West Africa.  About 1500 will remain.
Ten months ago, the historic deployment of U.S. military for a public health disaster sent Americans to help fight the world's largest outbreak of Ebola in history. The outbreak is estimated to cost Liberia, Guinea and Sierra Leone an estimated $1.6 billion in lost economic growth this year.  All of this has taken from 10-20% of their GDP by previous estimates.
This is an historic deployment of American military for the purpose of containment of a public health threat, and by definition, a threat to national and global security.
Post-deployment procedures in a memo from the Chairman of the Joint Chiefs of Staff 7 November 2014 provide the process by which service members, civilians and contractors returning from the Ebola Virus Disease (EVD) Outbreak areas will be subject to 21-day controlled monitoring.  Whether this is an anomaly in history or whether the military should prepare for deployments of this nature for the future is the question strategists should be addressing, now.

 

North Korea claims the US released Ebola in Africa

     While this headline is hardly newsworthy (or credible), given North Korea's historical record of making claims against the United States, it is a reminder of the same pattern of conduct that we should recognize. http://www.telegraph.co.uk/news/worldnews/asia/northkorea/11269553/North-Korea-accuses-US-of-developing-Ebola-virus.html  Quoted in the article, is a law professor from the University of Illinois (who teaches international law) who gave an interview in October 2014 that supports their claim. I had to listen to his interview before accepting the quote as accurate -- perhaps he was misquoted?  But I found he was not misquoted. He makes several claims that the U.S. is involved in making bioweapons and presents as proof our work in national laboratories on vaccines for exotic diseases like Ebola.  This is similar to the logic supporting the claim made by North Korea in the early 1950s during the Korean War (1950-53) that the U.S. had used bioweapons against them partially based on the logic that because the U.S. was vaccinating troops against yellow fever that it was likely the disease they would use against them with insect-vectors, Japanese style.  (See, M. Furmanski, "Misperceptions in preparing for biological attack:  an historical survey," (Rev. sci. tech. Off. int. Epiz., 2006, 25 (1), 53-70).
      There was more and the U.S.S.R. archives revealed when opened in 1998 that North Korea was being coached by the Soviet Union. In May 1951, North Korea charged that the U.S. had used smallpox and also multiple species of arachnids, clams, insects, mammals, paper leaflets etc. to spread plague, cholera, and other diseases on multiple occasions. A formal complaint was made to the UN Security Council. Long investigatory meetings followed and no allegations were ever proved. It was not until January 1998 when the Soviet archives revealed that the claims were not only wrong they were fraudulent.  For a full account and excellent footnoting of the case study of North Korea and their allegations of biowarfare against the United States see, Milton Leitenberg's chapter "False Allegations of U.S. Biological Weapons Use During the Korean War," in the book, "Terrorism, War or Disease?" (Stanford Univ Press, 2008).
      The trouble with misattribution in biological weapons and epidemics will continue to be difficult, even with advanced genomic identification of strains and the evolution of quickly evolving bacteria and viruses that can help to identify a timeline and origin of the disease. For example, the outbreak of cholera in Haiti during the earthquake disaster was traceable to the UN Peacekeepers and a group from Nepal who brought it into a country that had not seen cholera in 150 years.  However, even this clear evidence was not taken as a liability or calling for compensation from the United Nations.  We have a long way to go in attribution but even further in compensation for mass injury.
    These kinds of claims by North Korea and unsubstantiated claims by people who should know better just seem to keep us in the dark ages of bio-literacy.

Are new regulations called for? Study on bacteria and viruses found on planes is troubling

I made it a personal goal to bring attention to the problem of SARS and the benefits of a HEPA filter system on flights.  Trouble is, that we already have HEPA filter systems on flights, but the inability to change the filters can make them ineffective. I suggested an easier solution -- use ultraviolet light at the portal boarding the flight. I was told that the wind effect at the doorway into the plane would make all of that UV-disinfection pointless.  When I returned from my political appointment to my faculty position, I proposed a study to see if there really were hosts of bacteria and viruses on flights, and in TSA bins, etc.  I was pleased to see that these type of studies were funded recently at Auburn and University of Arizona and we have some hard data, at least about infection patterns and the presence of bacteria and viruses on surfaces with which passengers come in contact.

A microbiology study published in May 2014, found dangerous bacteria and viruses on surfaces on commercial flight seats, armrests, tray tables, bathrooms and just about everywhere else.   American Society for Microbiology. "Harmful bacteria can linger on airplane seat-back pockets, armrests for days." ScienceDaily. ScienceDaily, 20 May 2014.   I had always counted on the wisdom that viruses and bacteria are generally very fragile and cannot live long on surfaces not conducive to thriving.  However, this report shows the dangerous bacteria and viruses can last to infect passengers long after they were left by a previous host occupying the seat as much as 168 hours earlier.  Without disinfection of seats and armrests and tray tables between flights, it provides a regular garden of infection opportunities.  Here's a quote from the article announcing the findings:

In order for disease-causing bacteria to be transmitted from a cabin surface to a person, it must survive the environmental conditions in the airplane. In the study Vaglenov and his colleagues tested the ability of two pathogens, methicillin-resistant Staphylococcus aureus (MRSA) and E. coli O157:H7 to survive on surfaces commonly found in airplanes. They obtained six different types of material from a major airline carrier (armrest, plastic tray table, metal toilet button, window shade, seat pocket cloth, and leather), inoculated them with the bacteria and exposed them to typical airplane conditions.

 MRSA lasted longest (168 hours) on material from the seat-back pocket while E. coli O157:H7 survived longest (96 hours) on the material from the armrest.

Another study, by Dr. Gerba of University of Arizona, followed the passengers who were infected from another passenger with influenza. The findings appeared only in news articles and I was unable to substantiate this report by finding a peer-reviewed publication on this study by Dr. Gerba.  This graphic was provided in the news article and shows who was infected.

Further burdening the airlines with more regulations is a consideration, but the potential for sickness and spreading a global pandemic is reason enough for me to support mandatory wipedowns of the surface of planes between each flight. 

Ebola Updates --New app for iOS and Android devices

http://app.lk/sos-ebola This application is a central place to find the latest news about Ebola in any country, travel restriction information and general information. It is for both iOS and Android devices.  The U.S. media is uneven with its coverage of other countries and Ebola and this app is a good source for Ebola news around the world.