#Epidemic #preparedness: why is there a need to accelerate the #development of #diagnostics? (Lancet Infect Dis., summary)

[Source: The Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]

Epidemic preparedness: why is there a need to accelerate the development of diagnostics?

Prof Rosanna W Peeling, PhD, Maurine Murtagh, PhD, Piero L Olliaro, MD

Published: December 11, 2018 / DOI: https://doi.org/10.1016/S1473-3099(18)30594-2



Global epidemics of infectious diseases are increasing in frequency and severity. Diagnostics are needed for rapid identification of the cause of the epidemic to facilitate effective control and prevention. Lessons learned from the recent Ebola virus and Zika virus epidemics are that delay in developing the right diagnostic for the right population at the right time has been a costly barrier to disease control and prevention. We believe that it is possible to accelerate and optimise diagnostic development through a five-pronged strategy: by doing a global landscape analysis of diagnostic availability worldwide; through strategic partnerships for accelerating test development, in particular with vaccine companies to identify novel diagnostic targets; by creating and sharing repositories of data, reagents, and well characterised specimens for advancing the development process; by involving key public and private stakeholders, including appropriate regulatory bodies and policy makers, to ensure rapid access for researchers to diagnostics; and last, by fostering an enabling environment for research and access to diagnostics in the countries that need them. The need is great, but not insurmountable and innovative and faster development pathways are urgently required to address current shortfalls.

Keywords: Emerging Diseases; Infectious Diseases; Pandemic preparedness; Diagnostic tests.



#Fogarty International Center collaborative #networks in #infectious disease modeling: Lessons learnt in research and capacity building (Epidemics, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Epidemics. 2018 Oct 23. pii: S1755-4365(18)30029-X. doi: 10.1016/j.epidem.2018.10.004. [Epub ahead of print]

Fogarty International Center collaborative networks in infectious disease modeling: Lessons learnt in research and capacity building.

Nelson MI1, Lloyd-Smith JO2, Simonsen L3, Rambaut A4, Holmes EC5, Chowell G6, Miller MA1, Spiro DJ1, Grenfell B7, Viboud C8.

Author information: 1 Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda MD, USA. 2 Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda MD, USA; Department of Ecology & Evolutionary Biology, University of California, Los Angeles CA, USA. 3 Department of Science and Environment, Roskilde University, Roskilde, Denmark. 4 Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda MD, USA; Institute of Evolutionary Biology, University of Edinburgh, Edinburgh, Scotland. 5 Marie Bashir Institute for Infectious Diseases and Biosecurity, Charles Perkins Centre, School of Life and Environmental Sciences and Sydney Medical School, The University of Sydney, Sydney NSW, Australia. 6 Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda MD, USA; Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta GA, USA. 7 Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda MD, USA; Department of Ecology and Evolutionary Biology, Princeton University, Princeton NJ, USA. 8 Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda MD, USA. Electronic address: viboudc@mail.nih.gov.



Due to a combination of ecological, political, and demographic factors, the emergence of novel pathogens has been increasingly observed in animals and humans in recent decades. Enhancing global capacity to study and interpret infectious disease surveillance data, and to develop data-driven computational models to guide policy, represents one of the most cost-effective, and yet overlooked, ways to prepare for the next pandemic. Epidemiological and behavioral data from recent pandemics and historic scourges have provided rich opportunities for validation of computational models, while new sequencing technologies and the ‘big data’ revolution present new tools for studying the epidemiology of outbreaks in real time. For the past two decades, the Division of International Epidemiology and Population Studies (DIEPS) of the NIH Fogarty International Center has spearheaded two synergistic programs to better understand and devise control strategies for global infectious disease threats. The Multinational Influenza Seasonal Mortality Study (MISMS) has strengthened global capacity to study the epidemiology and evolutionary dynamics of influenza viruses in 80 countries by organizing international research activities and training workshops. The Research and Policy in Infectious Disease Dynamics (RAPIDD) program and its precursor activities has established a network of global experts in infectious disease modeling operating at the research-policy interface, with collaborators in 78 countries. These activities have provided evidence-based recommendations for disease control, including during large-scale outbreaks of pandemic influenza, Ebola and Zika virus. Together, these programs have coordinated international collaborative networks to advance the study of emerging disease threats and the field of computational epidemic modeling. A global community of researchers and policy-makers have used the tools and trainings developed by these programs to interpret infectious disease patterns in their countries, understand modeling concepts, and inform control policies. Here we reflect on the scientific achievements and lessons learnt from these programs (h-index = 106 for RAPIDD and 79 for MISMS), including the identification of outstanding researchers and fellows; funding flexibility for timely research workshops and working groups (particularly relative to more traditional investigator-based grant programs); emphasis on group activities such as large-scale modeling reviews, model comparisons, forecasting challenges and special journal issues; strong quality control with a light touch on outputs; and prominence of training, data-sharing, and joint publications.

KEYWORDS: Capacity building; Computational models; Control; Emerging disease threats; Infectious diseases; Influenza; Pathogen evolution; Policy; Transmission models

PMID: 30446431 DOI: 10.1016/j.epidem.2018.10.004

Keywords: Infectious Diseases; Emerging Diseases; Pandemic Preparedness; International Cooperation; Mathermatical Models.


#MERS #coronavirus #outbreak: Implications for emerging viral #infections (Diagn Microbiol Infect Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Diagn Microbiol Infect Dis. 2018 Oct 18. pii: S0732-8893(18)30502-9. doi: 10.1016/j.diagmicrobio.2018.10.011. [Epub ahead of print]

MERS coronavirus outbreak: Implications for emerging viral infections.

Al-Omari A1, Rabaan AA2, Salih S3, Al-Tawfiq JA4, Memish ZA5.

Author information: 1 Critical Care and Infection Control Department, Dr. Sulaiman Al-Habib Medical Group, and Al-Faisal University, Riyadh, Saudi Arabia. 2 Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia. Electronic address: arabaan@gmail.com. 3 Internal Medicine Department, Dr.Sulaiman Al-Habib Medical Group, Riyadh, Saudi Arabia. 4 Medical Department, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA. 5 College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia.



In September 2012, a novel coronavirus was isolated from a patient who died in Saudi Arabia after presenting with acute respiratory distress and acute kidney injury. Analysis revealed the disease to be due to a novel virus which was named Middle East Respiratory Coronavirus (MERS-CoV). There have been several MERS-CoV hospital outbreaks in KSA, continuing to the present day, and the disease has a mortality rate in excess of 35%. Since 2012, the World Health Organization has been informed of 2220 laboratory-confirmed cases resulting in at least 790 deaths. Cases have since arisen in 27 countries, including an outbreak in the Republic of Korea in 2015 in which 36 people died, but more than 80% of cases have occurred in Saudi Arabia.. Human-to-human transmission of MERS-CoV, particularly in healthcare settings, initially caused a ‘media panic’, however human-to-human transmission appears to require close contact and thus far the virus has not achieved epidemic potential. Zoonotic transmission is of significant importance and evidence is growing implicating the dromedary camel as the major animal host in spread of disease to humans. MERS-CoV is now included on the WHO list of priority blueprint diseases for which there which is an urgent need for accelerated research and development as they have the potential to cause a public health emergency while there is an absence of efficacious drugs and/or vaccines. In this review we highlight epidemiological, clinical, and infection control aspects of MERS-CoV as informed by the Saudi experience. Attention is given to recommended treatments and progress towards vaccine development.

KEYWORDS: Coronavirus; Infection; MERS; Middle East; Respiratory; Saudi Arabia; Transmission

PMID: 30413355 DOI: 10.1016/j.diagmicrobio.2018.10.011

Keywords: MERS-CoV; Emerging Diseases; Infectious Diseases; Nosocomial Outbreaks.


#Familiar #barriers still unresolved—a #perspective on the #Zika virus #outbreak #research response (Lancet Infect Dis., abstract)

[Source: The Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]

Familiar barriers still unresolved—a perspective on the Zika virus outbreak research response

Prof Marion Koopmans, PhD, Prof Xavier de Lamballerie, MD, Thomas Jaenisch, MD PhD on behalf of ZIKAlliance Consortium †

Published: November 09, 2018 / DOI: https://doi.org/10.1016/S1473-3099(18)30497-3



Research is an important component of an effective response to the increasing frequency of widespread infectious disease outbreaks. In turn, the ability to do such studies relies on willingness of partners in different regions to collaborate and the capacity to mount a rapid research response. The EU-funded ZIKAlliance Consortium has initiated a multicountry epidemiological, clinical, and laboratory research agenda to determine the incidence, risk factors, and outcomes of Zika virus infection in pregnant women and their children. We reviewed the timeline of patient cohort initiation in relation to the Zika virus epidemic and mapped key events regarding funding, regulatory approvals, and site preparation during this timeline. We then assessed barriers and delays that the international research team experienced through a systematic telephone interview. We have identified three major bottlenecks in the implementation of a swift response: the absence of a timeline for the funding process, delays in regulatory and ethical approval, and the challenging logistics of laboratory support, including diagnostics. These bottlenecks illustrate the clear and urgent need for implementing a strong and permanent global emerging infectious diseases research capacity that has structured funding, enables long-term partnerships, and develops basic clinical and laboratorial research and a response infrastructure that is ready to deploy.

Keywords: Zika Virus; Global Health; International Cooperation; Emerging Diseases.


Confronting the #threat of #bioterrorism: realities, challenges, and defensive strategies (Lancet Infect Dis., abstract)

[Source: The Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]

Confronting the threat of bioterrorism: realities, challenges, and defensive strategies

Prof Manfred S Green, MBChB, Prof James LeDuc, PhD, Prof Daniel Cohen, PhD, Prof David R Franz, PhD

Published: October 16, 2018 / DOI: https://doi.org/10.1016/S1473-3099(18)30298-6



Global terrorism is a rapidly growing threat to world security, and increases the risk of bioterrorism. In this Review, we discuss the potential threat of bioterrorism, agents that could be exploited, and recent developments in technologies and policy for detecting and controlling epidemics that have been initiated intentionally. The local and international response to infectious disease epidemics, such as the severe acute respiratory syndrome and west African Ebola virus epidemic, revealed serious shortcomings which bioterrorists might exploit when intentionally initiating an epidemic. Development of new vaccines and antimicrobial therapies remains a priority, including the need to expedite clinical trials using new methodologies. Better means to protect health-care workers operating in dangerous environments are also needed, particularly in areas with poor infrastructure. New and improved approaches should be developed for surveillance, early detection, response, effective isolation of patients, control of the movement of potentially infected people, and risk communication. Access to dangerous pathogens should be appropriately regulated, without reducing progress in the development of countermeasures. We conclude that preparedness for intentional outbreaks has the important added value of strengthening preparedness for natural epidemics, and vice versa.

Keywords: Biological hazards; Bioterrorism; Pandemic Preparedness; Infectious Diseases.


#Generation of therapeutic #antisera for #emerging viral #infections (npj Vaccines, abstract)

[Source: npj Vaccines, full page: (LINK). Abstract, edited.]

Article | OPEN | Published: 05 October 2018

Generation of therapeutic antisera for emerging viral infections

Rebecca Schmidt, Lea C. Beltzig, Bevan Sawatsky, Olga Dolnik, Erik Dietzel, Verena Krähling, Asisa Volz, Gerd Sutter, Stephan Becker & Veronika von Messling

npj Vaccines, volume 3, Article number: 42 (2018)



The recent Ebola virus outbreak has highlighted the therapeutic potential of antisera and renewed interest in this treatment approach. While human convalescent sera may not be readily available in the early stages of an outbreak, antisera of animal origin can be produced in a short time frame. Here, we compared adjuvanted virus-like particles (VLP) with recombinant modified vaccinia virus Ankara and vesicular stomatitis virus (VSV), both expressing the Ebola virus antigens. The neutralizing antibody titers of rabbits immunized with adjuvanted VLPs were similar to those immunized with the replication-competent VSV, indicating that presentation of the antigen in its native conformation rather than de novo antigen expression is essential for production of functional antibodies. This approach also yielded high-titer antisera against Nipah virus glycoproteins, illustrating that it is transferable to other virus families. Multiple-step immunoglobulin G purification using a two-step 20–40% ammonium sulfate precipitation followed by protein A affinity chromatography resulted in 90% recovery of functionality and sustained in vivo stability. Adjuvanted VLP-based immunization strategies are thus a promising approach for the rapid generation of therapeutic antisera against emerging infections.

Keywords: Infectious Diseases; Emerging Diseases; Serotherapy; Ebola; Nipah Virus.


#AIDS, #Avian #flu, #SARS, #MERS, #Ebola, #Zika… what next? (Vaccine, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Vaccine. 2017 Aug 16;35(35 Pt A):4470-4474. doi: 10.1016/j.vaccine.2017.04.082. Epub 2017 Jun 19.

AIDS, Avian flu, SARS, MERS, Ebola, Zika… what next?

Reperant LA1, Osterhaus ADME2.

Author information: 1 Artemis One Health Research Foundation, Utrecht, The Netherlands. 2 Artemis One Health Research Foundation, Utrecht, The Netherlands; Research Center for Emerging Infections and Zoonoses, University of Veterinary Medicine, Hannover, Germany. Electronic address: Albert.Osterhaus@tiho-hannover.de.



Emerging infections have threatened humanity since times immemorial. The dramatic anthropogenic, behavioral and social changes that have affected humanity and the environment in the past century have accelerated the intrusion of novel pathogens into the global human population, sometimes with devastating consequences. The AIDS and influenza pandemics have claimed and will continue to claim millions of lives. The recent SARS and Ebola epidemics have threatened populations across borders. The emergence of MERS may well be warning signals of a nascent pandemic threat, while the potential for geographical spread of vector-borne diseases, such as Zika, but also Dengue and Chikungunya is unprecedented. Novel technologies and innovative approaches have multiplied to address and improve response preparedness towards the increasing yet unpredictable threat posed by emerging pathogens.

KEYWORDS: Emerging; Epidemics; Preparedness; Virus

PMID: 28633891 DOI: 10.1016/j.vaccine.2017.04.082 [Indexed for MEDLINE]

Keywords: Infectious Diseases; Emerging Diseases; Pandemic Preparedness; Zika Virus; Ebola; MERS-CoV; SARS; HIV/AIDS; Avian Influenza.