Johns Hopkins pandemic exercise highlights US readiness gaps
The federal government needs to develop better vaccine production capacity, support strong global security, and bolster nationwide public health to be better prepared for the next pandemic, a high-level tabletop exercise yesterday sponsored by the Johns Hopkins Center for Health Security found.
The exercise, called Clade X, simulated a series of National Security Council–convened meetings of 10 US government leaders, played by experts in the fields of national security or epidemic response, according to a Center for Health Security news release. Among them were Margaret Hamburg, MD, former Food and Drug Administration commissioner, playing the role of Secretary of Health and Human Services, and Julie Gerberding, MD, reprising her role as director of the Centers for Disease Control and Prevention (CDC).
Their dialogue and decision making as the scenario unfolded highlighted significant uncertainties in US prevention and response capabilities, which have been hamstrung by policy challenges and underfunding.
The desktop scenario opened with an outbreak of a serious respiratory disease in Germany and Venezuela. The pathogen, dubbed Clade X, turned out to be an engineered strain of parainfluenza virus with elements of Nipah virus released by a terrorist group. Within a year, 150 million people worldwide and 15 million in the United States died from the fictitious but realistic pandemic.
At the conclusion of the exercise, the Center for Health Security presented six strategic policy goals that the US government needs to commit to for adequate pandemic preparedness:
- Develop the capability to produce new vaccines and drugs for novel pathogens within months, not years
- Pioneer a strong, sustainable global health security system
- Build a robust national public health system
- Develop a national plan to effectively harness all US healthcare assets
- Implement an international strategy for addressing research that increases pandemic risks
- Ensure the national security community is well prepared
New MERS case found in Saudi woman from Tabuk
In its first notification of a new case of MERS-CoV in 2 weeks, the Saudi Arabian Ministry of Health (MOH) said a woman from Tabuk has the coronavirus.
Officials diagnosed the 42-year-old woman as having MERS-CoV (Middle East respiratory syndrome coronavirus) after she presented with symptoms. The probable source of her infection, recorded in a May 13 report that was posted on the MOH site today, is listed as "primary," meaning it's unlikely she contracted the virus from another person.
The new case brings Saudi Arabia's MERS-CoV total since 2012 to 1,839, including 745 deaths. Two people are still being treated for their infections.
May 13 MOH report
CDC develops new rapid test for rabies that could mean fewer shots
A new rapid test for rabies designed for use in animals and developed by CDC scientists could mean that people exposed to potentially rabid animals could forego the weeks-long regimen of shots to prevent the deadly disease, according to a study in PLoS One and a CDC news release today.
The researchers used the LN34 assay to test 2,978 samples from Africa, the Americas, Asia, Europe, and the Middle East, 1,049 of which were positive via direct fluorescent antibody (DFA), the current gold standard for testing. Compared with DFA, LN34 displayed high diagnostic specificity (99.7%) and sensitivity (99.9%), and no DFA-positive samples were negative on LN34 testing. Even better, use of the LN34 assay led to the identification of one false-negative and 11 false-positive DFA results.
The LN34 test can be run on polymerase chain reaction testing platforms already widely used in the United States and abroad, without any extra training, the CDC said. And it yields results even from decomposing animal brain tissue. The DFA test, in contrast, must be interpreted by laboratory workers with special skills, extensive training, and a specific type of microscope.
"Many of the areas hardest hit by rabies are also the areas least prepared to run current tests to diagnose it," said Crystal Gigante, PhD, a CDC microbiologist and the study's first author. "The LN34 test has the potential to really change the playing field. Quickly knowing who needs to receive rabies treatment—and who does not—will save lives and families' livelihoods."
May 16 PLoS One study
May 16 CDC press release