Monday, May 14, 2018

Johns Hopkins Report: The Characteristics of Pandemic Pathogens



While there are a lot of contenders out there for sparking the next global health crisis, respiratory viruses - like influenza, SARS, MERS, etc. - are viewed with the greatest trepidation because of their track record of rapid human-to-human  spread and their potential for global dissemination.
But as SARS and MERS have demonstrated over the last 15 years, new - or previously unrecognized - respiratory viruses can emerge at any time (see PNAS: SARS-like WIV1-CoV Poised For Human Emergence for an example).
Meaning that while pandemic influenza remains at the top of our watch list, we may be faced with something radically different the next time around; Virus X, the one we don't know about yet.  

In order to help produce a framework for identifying naturally occurring microorganisms that could pose a global catastrophic biological risk (GCBR) - researchers at Johns Hopkins Center for Health Security have published a 17-page PDF report  called “The Characteristics of Pandemic Pathogens.”

Title: The Characteristics of Pandemic Pathogens
Authors: Amesh Adalja, Matthew Watson, Eric Toner, Anita Cicero, Thomas Inglesby
Date posted: May 10, 2018 
See also:
The Johns Hopkins Center for Health Security conducted this study to elucidate the characteristics of naturally occurring microorganisms that constitute a global catastrophic biologic risk (GCBR).

GCBRs are defined as “those events in which biological agents—whether naturally emerging or reemerging, deliberately created and released, or laboratory engineered and escaped—could lead to sudden, extraordinary, widespread disaster beyond the collective capability of national and international governments and the private sector to control. If unchecked, GCBRs would lead to great suffering, loss of life, and sustained damage to national governments, international relationships, economies, societal stability, or global security.

The overarching aim of the study was to provide an inductive, microbe-agnostic analysis of the microbial world to identify fundamental principles that underlie this special category of microorganisms that have potential to cause global catastrophe. Such principles could refine pandemic preparedness by providing a new framework or lens through which to survey the threat landscape of infectious diseases in order to better anticipate, prepare for, and respond to GCBR threats.

For more details, you can also view the press release:

Study by Center for Health Security identifies characteristics of microorganisms most likely to cause a global pandemic

New forward-looking framework for special category of the most serious emerging infectious diseases will help inform future preparedness and response efforts

By Nick Alexopulos | May 10, 2018

Infectious disease preparedness work focuses predominantly on an historical list of pathogens derived from biological warfare agents, political considerations, and recent outbreaks. That fails to account for the most serious agents not currently known or without historical precedent, write scholars from the Johns Hopkins Center for Health Security in a new report on the traits of microorganisms with high pandemic potential.

The report, “The Characteristics of Pandemic Pathogens,” establishes a framework for identifying naturally occurring microorganisms that pose a global catastrophic biological risk (GCBR) and makes broad recommendations for improving GCBR preparedness efforts. GCBRs are events in which biological agents could lead to a sudden, extraordinary, widespread disaster beyond the collective capability of national and international governments and the private sector to control. No exhaustive catalogue of GCBR culprits exists, leaving the health security community to rely on historical examples (e.g., 1918 Spanish Flu) to guide their preparedness priorities.

“Health security preparedness needs to be adaptable to new threats and not exclusively wedded to historical notions,” said Amesh Adalja, MD, project lead and senior scholar at the Center. “A more active-minded approach to this problem will, in the end, help guard against a GCBR event occurring.”

Adalja’s project team included senior scholar Eric Toner, MD, and senior analyst Matthew Watson. To formulate the findings and recommendations in their report, they reviewed published literature and reports on emerging infectious disease characteristics, the pathogenic potential of microbes, and other related topics; interviewed more than 120 technical experts from academia, industry, and government; and convened a meeting of a subset of those experts to discuss preliminary analysis of the information the team had gathered.

The first and primary finding presented in the report outlines common characteristics of a potential GCBR-level pandemic pathogen. Its mode of transmission, the team concluded, will most likely be respiratory. It will be contagious during the incubation period, prior to symptom development, or when infected individuals show only mild symptoms. Finally, it will need specific host population factors (e.g., immunologically naïve persons) and additional intrinsic microbial pathogenicity characteristics (e.g., a low but significant case fatality rate) that together substantially increase disease spread and infection.

(Continue . . . )

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