Health and Infectious Disease Evidence File

Apr19: New Health and Disease Information: Indicators and Surprises
Why Is This Information Valuable?
The escalating Ebola hemorrhagic fever outbreak in Democratic Republic of the Congo (current case count 1,600, which is increasing at an accelerating rate) amid a deteriorating local security situation). The case fatality rate is 63%.

Elsewhere, African Swine [hemorrhagic] Fever has been spreading rapidly in China, world’s largest pig producer. It is a highly contagious virus (between pigs) and has a very case fatality rate. Anytime a contagious deadly disease infects pigs, there is an elevated threat of a viral mutation or recombination that could lead to human infection (e.g., as in the case of strains of the influenza virus), because of the similarity of pig and human respiratory tracts.
Both of these situations remind us of the potential threat posed by infectious diseases and the substantial supply and demand side shocks they can cause. These wildcard risks are always out there, which makes early detection and accurate assessment of the threat they pose critical to avoiding the large downside losses they potentially can cause.
Nov18: Health and Infectious Disease: Indicators and Surprises
Why Is This Information Valuable?
Biodefense in the Age of Synthetic Biology”, by the US National Academy of Sciences
This new report provides more specific information on the nature of a developing threat.

“Synthetic biology expands what is possible in creating new weapons. It also expands the range of actors who could undertake such efforts and decreases the time required.”

“Based on this study’s analysis of the potential ways in which synthetic biology approaches and tools may be misused to cause harm, the following specific observations were made:

“Of the potential capabilities assessed, three currently warrant the most concern: (1) re-creating known pathogenic viruses, (2) making existing bacteria more dangerous, and (3) using microbes to make harmful biochemicals “

“With regard to pathogens, synthetic biology is expected to (1) expand the range of what could be produced, including making bacteria and viruses more harmful; (2) decrease the amount of time required to engineer such organisms; and (3) expand the range of actors who could undertake such efforts. The creation and manipulation of pathogens is facilitated by increasingly accessible technologies and starting materials, including DNA sequences in public databases. A wide range of pathogen characteristics could be explored as part of such efforts.”

“With regard to chemicals, biochemicals, and toxins, synthetic biology blurs the line between chemical and biological weapons. High-potency molecules that can be produced through simple genetic pathways are of greatest concern, because they could conceivably be developed with modest resources and organizational footprint.”

“It may be possible to use synthetic biology to modulate human physiology in novel ways. These ways include physiological changes that differ from the typical effects of known pathogens and chemical agents. Synthetic biology expands the landscape by potentially allowing the delivery of biochemical by a biological agent and by potentially allowing the engineering of the microbiome or immune system…Although unlikely today, these types of manipulations may become more feasible as knowledge of complex systems, such as the immune system and microbiome, grows.” [Note that this was written before the disclosure of the use of CRISPR technology in China to change human DNA to enhance resistance to smallpox].