Influenza

Penicillin WWII Advertisement. (Credit: Schenley Laboratories, Inc., Lawrenceburg, Indiana)

During 1940s, penicillin, the first commercially available antibiotic, was hailed as a “wonder drug.”  Penicillin helped make WWII the first American war where infection was not the major cause of death.  But by the 1950s, antibiotic resistance became widespread.  Scientists were engaged in a veritable arms race, constantly modifying and developing new classes of antibiotics to beat resistance while bacteria, literally generations ahead, continued to defeat their advances.  The same story is true for antivirals, such as Tamiflu (oseltamivir).  Multidrug-resistant bacteria and viruses are an increasing problem, especially in hospital settings.  Scientists are now looking to develop new methods, beyond standard antibiotics and antivirals, to combat bacterial and viral diseases.  Within the past month, many new treatments have been discussed, including the use of small interfering RNA (siRNA).

In an era of increased globalization, public health and surveillance are playing an increased role in biosecurity. Whether novel pathogens are intentionally created bioweapons or naturally occurring emerging infectious diseases, recognizing the threat is a necessary prerequisite to countering it. This panel brings together representatives from Federal public health agencies, industry researchers, and representatives of NGO’s.

Today at 1pm EST HHS secretary Kathleen Sebelius, DHS Secretary Janet Napolitano and acting Director of the CDC Richard Besser will be webcast answering questions about Swine Flu from the American people.  The webcast will be available at www.hhs.gov and questions can be emailed to hhsstudio@hhs.gov.

The World Health Oraganization has now raised the Pandemic Alert Level to Phase 5 meaning that they believe there is a “strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.” There currently have been 109 confirmed cases of Swine Flu in the US and one death. Continually updated information on the situation and statistics as well as fact sheets and interim guidance documents can be found on the CDC Swine Flu page at www.cdc.gov/swineflu.

To begin the day the NBSB listened to presentations from each of the members of the Public Health Emergency Medical Countermeasures Enterprise (PHEMCE). The Enterprise is coordinated within HHS by the Assistant Secretary for Preparedness and Response and includes the NIH, CDC, FDA and BARDA. PHEMCE’s role in HHS is to coordinate the research, development, acquisition and deployment of medical countermeasures to chemical, biological, radiological or nuclear (CBRN) threats. Many of the topics the NBSB will consider and provide recommendations on will fall within the PHEMC Enterprise, so the board heard a representative from each of the agencies describe their efforts and role in PHEMCE. The morning session ended with presentations from Bruce Gellin giving an overview of the HHS pandemic flu program and Robin Robinson detailing BARDA’s pandemic preparedness and response activities.

During the afternoon session the board got down to business. After being presented with information on the possible topics that they were considering, the NBSB voted for 4 specific topics and formed subcommittees for each.

First the NBSB wanted to address the issue of pandemic influenza preparedness. The subcommittee will evaluate current research, identify the gaps, and then report to the whole board to begin making recommendations.

The second subcommittee will review the US government research portfolio to determine whether efforts are as integrated as they could be. They too will return their findings to the whole board with the goal of making recommendations to increase collaboration and avoid duplication of efforts.

The third subcommittee was commissioned to look at disaster medicine. They will take HSPD-21 as a framework for evaluation and further development of a national disaster medicine plan. It will include the possibility of promoting ‘disaster medicine’ as a new discipline and setting up dedicated training courses and programs.

Finally, it was agreed that a subcommittee be set up to look at the gaps in the medical countermeasures marketplace. This subcommittee will focus on the private sector and look at ways to engage their involvement in countermeasures development.

It was also agreed that the issue of special and at-risk populations and the issue of communications and data interoperability not be stand alone topics. They will be integrated into each of the four subcommittees and a decision to exclude them would need to be explicitly justified.

Finally the members of the NBSB volunteered their placement on subcommittees within their areas of expertise and subcommittee chairs were appointed. Andrew Pavia will chair the pandemic influenza subcommittee, Patrick Scannon; the government research evaluation subcommittee, Jim James; the disaster medicine subcommittee and John Parker; the gaps in countermeasure marketplace subcommittee. The NBSB will meet again in 6 months to hear reports from the subcommittees and make recommendations.

Written with Cheryl Vos

The National Biodefense Science Board (NBSB) began their inaugural meeting yesterday in Washington DC. The board, made up of 13 voting members and 21 non-voting ex officio representatives, was created as part of the 2006 Pandemic and All-Hazards Preparedness Act. The NBSB was chartered with the task of providing expert advice to the Department of Health and Human Services (HHS) Secretary on science, technology, and other matters of special interest on chemical, biological, radiological, and nuclear issues, including both naturally occurring and deliberate events.

The members include Patricia Quinlisk (Iowa Dept. of Public Health, chair), James J. James (American Medical Association), Steve Cantrell (Denver Health Medical Center), Eric Rose (SIGA Technologies), Albert Di Rienzo (Welch Allyn), Ken Dretchen (Georgetown University Biosecurity Institute), John Grabenstein (Merck Vaccine Division), Ruth Berkelman (Emory University , Thomas MacVittie (University of Maryland School of Medicine), John Parker (SAIC), Andrew Pavia (University of Utah Medical Center) Roberta Carlin (American Association on Health and Disability), and Patrick Scannon (XOMA).

After the morning introductory session, the group listened to several talks presented by executive branch officials that discussed current US Government policies on preparedness and response. After this, the group heard another series of talks that outlined possible topics and issues that the NBSB could focus on initially. The broadly defined proposed topics, developed by officials at HHS, are as follows- an evaluation of research and development components of the HHS influenza preparedness strategy, innovation and medical countermeasure development, how to address gaps in the medical countermeasures marketplace, modeling and metrics to inform medical consequence assessment, and considerations for special and at-risk populations.

Today the group will make decisions about how to go forward as a board. The group will try to prioritize topics and determine how to fulfill their charge. Since the mandate to the NBSB is so broad, many members agreed that it is important to determine the group’s focus in a way that considers issues based on their timeliness and achievability.

The agenda for the meeting is here
NBSB main page
Members list

Written by Nate Hafer