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As we await novel compounds from a relatively apathetic industry, we are resurrecting antibiotics of which we have an outdated understanding. and that carry the potential for substantial side effects: polymyxins.

The Great Debate: Polymyxin B Versus Polymyxin E

Along with a 1 reported case in Massachusetts, the

New Hampshire Department of Health and Human Services (DHHS) has confirmed a person infected with eastern equine encephalitis (EEE) has died. The public health agency said the person was hospitalized due to severe central nervous system disease. The last reported human EEEV infection in New Hampshire was in 2014, when DHHS identified 3 human infections, including 2 fatalities. In the same statement, DHHS mentions there has been 1 confirmed case in Vermont this summer.

On August 16, the Massachusetts Department of Public Health (MDPH) released a statement discussing the confirmation of the first human case of EEE in the state this year. The confirmed case was discovered in an 80 year old man who was exposed to the vector borne disease in Worcester County. As a result, the risk level in the local communities of Douglas, Oxford, Sutton, and Webster has been raised to critical, and in Dudley, Northbridge, and Uxbridge the risk is increased to high.

Additionally, the neighboring communities of Auburn, Charlton, Grafton, Leicester, Mendon, Millbury, Millville, Southbridge, and Upton are now considered at moderate risk according to MDPH.

“This is the first time we have seen a person infected with EEE in Massachusetts since 2020,” Public Health Commissioner Robbie Goldstein, MD, PhD, said in a statement. “EEE is a rare but serious disease and a public health concern. We want to remind residents of the need to protect themselves from mosquito bites, especially in areas of the state where we are seeing EEE activity.

Though very rare, EEE is serious and a potentially fatal disease that can affect people of all ages. EEE is generally spread to humans through the bite of an infected mosquito. There were 12 human cases of EEE in Massachusetts in 2019 with 6 deaths, and 5 human cases with 1 death in 2020. There were no human cases of EEE in Massachusetts in 2021, 2022, or 2023.

EEE has a fatality rate of 33% to 70%, with most deaths occurring 2–10 days after the onset of symptoms.

In addition to a high mortality rate, long-term physical and mental complications, including permanent neurological deficits have been identified in many people who survive EEE.

Plymouth is approximately 40 miles south of Boston along the coast, and Worcester County is in the middle of the state, so the 2 areas are not in close proximity, but due to the elevated risk locally, the town of Plymouth decided to take action in response to outdoor parks. As of last Friday, all town public parks and fields are close daily from dusk until dawn.

“As Mass DPH has now elevated Plymouth’s EEE risk status to high, it is important to take extra precautions when outdoors and follow state and local health guidelines to avoid unnecessary risk to exposure to EEE. The health and safety of our community, residents, and visitors remain our priority,” Plymouth’s Commissioner of Health and Human Services, Michelle Bratti, said in a statement.

According to the Centers for Disease Control and Prevention (CDC) most people who are infected with the virus do not develop symptoms; however, for those that do, the date from the bite to the onset of the illness is 4 to 10 days. EEE can also result in fever or neurologic disease. The type of illness will depend on the age of the person and other factors. Those who are infected can develop meningitis.

There are no FDA-approved treatments for EEE and for patients who develop severe cases, they can be hospitalized to receive supportive treatment.

Over the weekend, MDPH detailed plans of spraying for mosquitos including aerially in areas of Plymouth County, and truck-mounted spraying in parts of Worcester County. As of Saturday, 10 communities in Massachusetts were raised to high or critical risk for EEE virus.

“The risk from EEE is high in parts of Plymouth County and critical in parts of Worcester County,” State Epidemiologist Catherine M. Brown, DVM, said in a statement. “In addition to recommending that people use mosquito repellent with an EPA-registered active ingredient and clothing to reduce exposed skin, we also recommend that evening outdoor events be rescheduled to avoid the hours between dusk and dawn. The mosquitoes most likely to spread EEE are most active during the dusk to dawn hours.”

There are preventative strategies to avoid EEE, and the MDPH has listed such measures 

For those who live in Massachusetts and want more information on EEE, it can be found 

 or by calling the DPH Division of Epidemiology at 617-983-6800.

1.NH DHHS Identifies Person Infected with Eastern Equine Encephalitis Virus in New Hampshire.The New Hampshire Department of Health and Human Services. August 27, 2024. Accessed August 28, 2024.
https://www.dhhs.nh.gov/news-and-media/nh-dhhs-identifies-person-infected-eastern-equine-encephalitis-virus-new-hampshire
2. State health officials announce season’s first human case of Eastern Equine Encephalitis in Massachusetts. MDPH. August 16, 2024. Accessed August 27, 2024.
https://www.mass.gov/news/state-health-officials-announce-seasons-first-human-case-of-eastern-equine-encephalitis-in-massachusetts
3.Plymouth to Close all Public Parks and Fields from Dusk to Dawn. Town of Plymouth. August 23, 2024. Accessed August 27, 2024. PDF.
4. Eastern Equine Encephalitis: Symptoms, Diagnosis, and Treatment. CDC. May 15, 2024. Accessed August 27, 2024.
https://www.cdc.gov/eastern-equine-encephalitis/symptoms-diagnosis-treatment/index.html
5. State officials announce plans to spray for mosquitoes in sections of Worcester and Plymouth counties due to EEE. MDPH. August 24, 2024. Accessed August 27, 2024. 
https://www.mass.gov/news/state-officials-announce-plans-to-spray-for-mosquitoes-in-sections-of-worcester-and-plymouth-counties-due-to-eee



The town of Plymouth decided to prohibit people from using the parks from dusk to dawn due to concerns over eastern equine encephalitis after a man contracted the rare disease in the state.

Concerns Over Mosquito-Borne Illness Causes Massachusetts Town to Create Curfew for Parks, Spraying in Counties

The COVID-19 pandemic raised urgent calls from health experts worldwide for governments to form a cohesive strategy to prepare for future pandemics—while also putting measures in place to prevent them. Towards that end, the World Health Organization is leading negotiations for a global pandemic preparedness treaty, and it’s set to present its findings at the World Health Assembly in 2025.

Regardless of the specifics of the pandemic preparedness plan, there’s no doubt immunology researchers will play a prominent role in carrying out its goals. There has already been an uptick in studies aimed at improving the understanding of the human immune system and applying that knowledge to prepare for future pandemics. This work is centered around sophisticated and rapidly evolving genomics technologies. For example, RNA researchers can now use single-cell transcriptomics to study gene expression of individual cells in the immune system, deriving much more precise knowledge than they could if they relied on traditional technologies that only allowed them to average data derived from many different cell populations.

Insights gained from this rapidly evolving field, dubbed “immunomics,” will improve the scientific understanding of the human response to novel pathogens, including how people contract and spread viruses, who is most susceptible to life-threatening complications, and how the response to vaccines can vary among patients. Armed with this information, health systems will be able to react faster and more effectively to emerging pathogens in the future.

Automation of RNA sequencing is key to immunomics, because it enables researchers to collect more data and process it faster than they ever could before. This helps scientists ask and answer more complex questions so they can build a toolkit for pandemic preparedness.

Improving Single-Cell Techniques to Probe Immune Response

Immunomics involves mapping the genes of immune cells with exquisite detail, capturing RNA, proteins and all of the other components of the cell types that govern the immune response to pathogens. This level of immune profiling is difficult to do in traditional cell culture, because the activation of immune cells happens in the context of multiple other cell types and antigens. Until recently, researchers isolated individual antigens and tested them against immune cells to measure responses—a costly, time-consuming approach that limited their ability to visualize the whole immune system.

Laboratory automation combined with single-cell transcriptomics technology is enabling much more sophisticated immunomics studies. For example, an automated method for library preparation can support up to 96 samples per run and reduce hands-on time from 7.5 hours to 40 minutes. In a 2024 experiment comparing manually prepared DNA from 20,000 human kidney cells and 500 blood cells, this automated method generated 216 libraries, vs. just 80 libraries generated from three manual methods. The complexity and sensitivity of the results were comparable between the automated and manual workflows.

 What’s more, researchers who had never used the automated workflow before were able to learn it quickly and generate comparable results to those using a more manual technique.

There are several potential uses for immunomics research that will help improve future pandemic responses. One example is vaccine design. Researchers who are developing RNA vaccines against emerging pathogens need a quick way to analyze the effectiveness of the vaccines in being absorbed by the body and generating the desired immune response. Automated immunomics workflows that can quickly churn out results from 96 patient samples simultaneously help achieve that outcome, while at the same time reducing errors and the risk of contamination that comes from manual processes.

Immunomics can also help drive vaccination strategies during pandemics. By shedding light on “immune memory”—the length of time vaccine-induced antibodies stay in the body and continue fighting the infection—researchers can help government officials and health authorities make recommendations for booster strategies. Immunomics research is also critical for adjusting vaccines to tackle evolving strains of novel viruses.

The COVID-19 pandemic prompted calls from the WHO and other health authorities to improve the prevention of “zoonotic spillover,” the transmission of viruses from animals to people.

Here, too, immunomics research is critical. Single-cell analysis and other advanced techniques can uncover biomarkers and environmental vectors that allow authorities to closely track viral transmission. For example, by studying viral DNA collected from minks on two farms and from the people working with them, a team of Dutch researchers showed in 2020 that the novel coronavirus was being transmitted among the animals, and that one farm worker likely caught the disease from a mink.

 The ability to track inter-species transmission of novel pathogens could help authorities better understand the evolution and spread of diseases, thereby improving prevention and containment strategies.

The effort to better track and control the spread of emerging viruses in densely populated areas is another priority for health systems, and automating sample-processing workflows will be critical to reaching that goal. The value of automation in that process was demonstrated in a study carried out at Cornell University starting in 2020. Anticipating the need to process at least 8,000 COVID-19 tests per day, researchers used robotics and electronic data-transfer methods to automate processes that had been done manually, including sample and reagent transfer for 96-well plates, and pooling and labeling specimens. By the end of February 2023, the lab was processing up to 10,300 samples per day, exceeding the university’s surveillance needs.

Shifting to Proactive Pandemic Preparedness

Ideally, our understanding of the immune system will improve to the point where in the future, vaccines can be developed and widely distributed well before novel pathogens become pandemics. To achieve that goal, researchers will need to uncover many more molecular details of how the immune system responds to foreign invaders.

One organization that’s contributing to that effort is the Human Immunome Project, a global network of research sites that are building diverse datasets of the human immune system. Their goal is to use advanced omics technologies, including single-cell transcriptomics, to generate datasets and make artificial-intelligence models of the immune system. The models will be publicly available in the hopes of accelerating medical discovery.

Ultimately, immunomics advances will allow the world’s health authorities to stay ahead of emerging pathogens, more effectively containing their spread, while developing vaccines much faster than they ever could before. To get there, researchers will need advanced, efficient tools for generating and analyzing hundreds of thousands of immunomics datapoints, enhanced by automation. This will be key to shifting from a reactive approach to pandemics—as we saw after the COVID-19 outbreak—to a more proactive approach that’s sure to save lives.



This is the second in a series on preparedness. Check back in tomorrow as we discuss a potential new approach to biocontainment.

References
1.Governments progress on negotiations for a pandemic agreement to boost global preparedness for future emergencies. World Health Organization website. 

https://www.who.int/news/item/20-09-2024-governments-progress-on-negotiations-for-a-pandemic-agreement-to-boost-global-preparedness-for-future-emergencies

. Published September 20, 2024. Accessed December 13, 2024.
2.Zhao A., et al. Accelerating Single Cell Research by Automating Gene Expression Library Construction for 10x Genomics GEM-X Chemistry on the Biomek i7 Hybrid Workstation. 10X Genomics, Beckman Coulter Life Sciences. 2024.
3.Gao J, Zhang C, Wheelock A, et al. Immunomics in one health: understanding the human, animal, and environmental aspects of COVID-19. 

2024 Sep 4;15:1450380. doi: 10.3389/fimmu.2024.1450380.
4.Prevention of zoonotic spillover. World Health Organization website. 

https://www.who.int/publications/m/item/prevention-of-zoonotic-spillover

. Published February 22, 2023. Accessed December 13, 2024.
5.Oreshkova N, Molenaar RJ, Vreman S, et al. SARS-CoV-2 infection in farmed minks, the Netherlands, April and May 2020. 

.
6.Gao J, Zhang C, Wheelock A, et al. Immunomics in one health: understanding the human, animal, and environmental aspects of COVID-19. 

2024 Sep 4;15:1450380. doi: 10.3389/fimmu.2024.1450380.
7.Laverack M, Tallmadge RL, Venugopalan R, et al. The Cornell COVID-19 Testing Laboratory: A Model to High-Capacity Testing Hubs for Infectious Disease Emergency Response and Preparedness. 

2023, 15, 1555. https://doi.org/10.3390/v15071555.
8.Human Immunome Project: Vision, Mission, & Values. Human Immunome Project website. 

https://www.humanimmunomeproject.org/about/mission-vision/

The COVID-19 pandemic underscored the urgent need for global pandemic preparedness. The World Health Organization (WHO) is leading efforts to establish a global treaty to address future pandemics, with findings expected in 2025. Central to this preparedness is immunomics, a field leveraging advanced genomics technologies to study the immune system at unprecedented levels of detail.

Pandemic Preparedness: How Immunomics Technology is Leading the Way

The federal government is working on measures to mitigate the potential impact including looking at vaccines, therapies, and other strategies

How PRepared are we for Avian Influenza

When it comes to public health, and the idea of being prepared for a potential outbreak or pandemic, there are some objective measures that can be put into place including stockpiling vaccines and therapies, having emergency plans, and carrying out surveillance measures to name a few.

The federal government, for example, is working to make sure there are vaccines and therapies available to the general public if they are needed. The Centers for Disease Control and Prevention (CDC) is looking to prepare by developing candidate vaccine viruses (CVV) for avian influenza (H5). “CVVs are used to produce influenza vaccines. Having a CVV that protects against H5 bird flu in humans is an important step for being prepared for an H5 vaccination program, if one is needed,” the federal agency writes on its site.

The Biomedical Advanced Research and Development Authority (BARDA) overees the National Pre-pandemic Influenza Vaccine Stockpile (NPIVS). And the stockpile has enough raw materials to develop vaccine doses to immunize critical care workers and at-risk populations in the early phases of a needed response. And they also have enough materials to make millions of additional doses within weeks.

And separately there are a handful of vaccine candidates in development. The US Department of Health and Human Services (HHS) announced last week it was going to provide approximately $590 million to Moderna to accelerate the development of mRNA-based pandemic influenza vaccines and enhance mRNA platform capabilities so that the US is better prepared to respond to other emerging infectious diseases.

And in terms of therapies, the Strategic National Stockpile has millions of treatment courses of antivirals including, oseltamivir (Tamiflu), which is expected to work against avian influenza.

Of course, learning from history so as not to repeat it is an age-old adage. And certainly, fresh off the COVID-19 pandemic, there are many things we can glean when considering a potential avian influenza outbreak.

“I think we've learned a lot of important lessons about what we've done well and what we've done not so well in responding to a pandemic,” Hopkins said. “There were tremendous investments from the federal government, from states, from others, to help us respond, to grow our public health workforce, to reach out to communities to get vaccine into arms, without regard for insurance. So we learned an awful lot. Unfortunately, a lot of that spending, that money that was invested is gone. So in a lot of ways, we've learned, but we don't have the resources to respond as effectively now.”

He also mentions the need for the federal government’s continued vigilance to monitor the ongoing situation. “We know that this can be a serious infection and can cause death…This needs to be on our radar,” Hopkins said. “Ongoing public health surveillance, ongoing biosecurity around cattle farms, and around our poultry operations is really critical.”

This is the first in a short series on preparedness, check back in tomorrow and Thursday as different authors tackle biocontainment and how immunomics may help in preparing for future pandemics.

References
1. CDC Activities and Accomplishments to Date in 2024—2025 H5 Bird Flu Response. CDC. January 17, 2025. Accessed January 21, 2025.


https://www.cdc.gov/bird-flu/spotlights/h5n1-response-01172025.html


2.ASPR’s Response to H5N1 Bird Flu. Administration for Strategic Preparedness & Response. Accessed January 21, 2025.
https://aspr.hhs.gov/H5N1/Pages/default.aspx



The federal government is working on measures to mitigate the potential impact including looking at vaccines, therapies, and other strategies. Robert Hopkins, Jr, MD, medical director, National Foundation for Infectious Diseases (NFID), provides some insights on our preparation now and lessons learned from the pandemic. 

How Prepared Are We For Avian Influenza? 

The Centers for Disease Control and Prevention (CDC) is preparing for staff cuts and withholding information, which can impact the ability of providers and other stakeholders ability to provide the nation with significant public health information.   

Ways the Federal Government Changes May Influence Avian Influenza Surveillance and Disease Prevention 

With the avian influenza circulating greatly in animals including birds, cattle, and cats, one of the bigger concerns around this is how severe and virulent the virus could become—if given the right settings and circumstances—and this goes from a mostly animal-to-animal transmission to zoonotic transmission to finally one that jumps from person-to person.

"We've had one transmission from a bird to a human, which resulted in the individual's death. Bird flu can carry a 50% to 60% mortality in the right settings, and so we're concerned that it may evolve to become more infectious,” American Public Health Association's (APHA) Executive Director Georges C Benjamin, MD, said. "It's already shown they can move from one species to another, and then eventually it could change in a way that becomes adaptive to humans, easily spread by humans, and if it also becomes easily spreadable and more lethal, we would have a significant outbreak. And I can tell you it would probably be worse than COVID."

And as this form of influenza is evolving quickly, there is a need to keep up surveillance, especially at the federal government level. This is where the role of the CDC is vital to keep the public up-to-date on disease threats and respond to reports of individual cases or outbreaks.

News reports are offering 2 ways in which the CDC could become greatly affected under the Trump Administration.

 reported that the CDC is preparing for layoffs. The federal agency’s staff were told to list the staff who were considered probationary and temporary.

In addition, the agency’s leadership was asked to develop a list of people who “were mission critical and not mission critical.”

Morbidity and Mortality Weekly Report (MMWR),

 investigators wrote how avian influenza was transmitted from cats to people and then that report was deleted off the site.

 This weekly report was not published for 2 weeks, and now when it is, the administration is withholding necessary public information.

Will Trump Administration’s Funding Pauses, Withdrawal from WHO Hamper Public Health?

“If you look at all the things they've done: diminishing the workforce, halting research, stopping the study groups, limiting publication of the various scientific articles, including the 

…I worry about it, and the fact that everything that they've done will diminish our capacity to respond to any emergency, any new health threat,” Benjamin said.

In terms of our readiness, Benjamin does not believe we are prepared for a public health emergency. “If we had a big outbreak today, I don't know that we'd be able to handle it,” he said. 

References
1. Huang P, Stone W. Morale plummets at the CDC as staff fear job losses. February 7, 2025. Accessed February 10, 2025.
https://www.npr.org/sections/shots-health-news/2025/02/07/nx-s1-5290273/cdc-employee-lists-doge
2. Mandavilli A, Anthes E. CDC. Posts, Then Deletes, Data on Bird Flu Spread Between Cats and People. NY Times. February 6, 2025. Accessed February 10, 2025.


https://www.nytimes.com/2025/02/06/health/cdc-bird-flu-cats-people.html

The Centers for Disease Control and Prevention (CDC) is preparing for staff cuts and the Trump Administration may be withholding public health information in one of the agency's publications, which can impact disclosing health information being seen by providers and other stakeholders.

Federal Government Changes May Influence Avian Influenza Surveillance and Disease Prevention 

This is the second in a series looking at the intersection of government and public health. 

Will Trump Administration’s Funding Pauses, Withdrawal from WHO Hamper Public Health? 

On January 20, the Trump Administration issued an executive order announcing its withdrawal from the World Health Organization (WHO).

The order stated it was, “due to the organization’s mishandling of the COVID-19 pandemic that arose out of Wuhan, China, and other global health crises, its failure to adopt urgently needed reforms, and its inability to demonstrate independence from the inappropriate political influence of WHO member states. In addition, the WHO continues to demand unfairly onerous payments from the United States, far out of proportion with other countries’ assessed payments. China, with a population of 1.4 billion, has 300 percent of the population of the United States, yet contributes nearly 90 percent less to the WHO."

“I think we're going to find out more about what it means going forward,” said Jason Gallagher, FCCP, FIDP, FIDSA, BCPS, clinical professor at Temple University School of Pharmacy and clinical pharmacy specialist in Infectious Diseases at Temple University Hospital, of the WHO withdrawal. “I think as much as anything else, it's a signal that is concerning for the degree to which the United States wants to engage in the rest of the world, and related to public health.”

“Through membership in the WHO the US gets influence on health policy around the world. And I don't think that's the kind of thing you want to give up. Within the more tangible benefits, WHO is doing epidemiology work and detection of outbreaks. That seems to be where some of the disagreement with them has been at least from a gut opinion perspective.”

And while it was believed to be a gradual withdrawal with WHO, within a week, a memo came from the Centers for Disease Control and Prevention’s (CDC), Deputy Director for Global Health John Nkengasong, PhD, which was written to senior leaders at the agency telling employees that work with the WHO must immediately stop and to “await further guidance.” Congress will need to approve withdrawing from the WHO, and the country has to provide a 1-year notice.

Now is Not the Time for Funding Pauses, Cutting Ties With Health Organizations

Within the administration’s flurry of executive orders, there was a pause put on federal communications. This included not publishing the CDC’s 

Morbidity and Mortality Weekly Report (MMWR)

 last Thursday. It is a significant public health publication. This pause on not publishing this report was the first time in decades. This report has been publishing since the 1950s. 

“This is a premier health publication that everybody reads…multiple times a year you take a peek at that one because people are talking about something that has been described in 

,” Gallagher said. "It's used for other publications as well; recommendations, guidelines, and so forth that can go in other places, but it really has been a stalwart of US public health and our information network about health for decades."

 was not published yesterday—marking 2 weeks in a row—and it remains to be seen, if and when, this will come back.

In a January 27 memo sent by Matthew Vaeth, acting director, Office of Management and Budget (OMB), to the heads of executive departments and agencies, a pause was placed on all funding, including research grants.

The memo stated, “to the extent permissible under applicable law, federal agencies must temporarily pause all activities related to obligation or disbursement of all federal financial assistance, and other relevant agency activities that may be implicated by the executive orders, including, but not limited to, financial assistance for foreign aid, nongovernmental organizations, DEI, woke gender ideology, and the green new deal.”

The memo also stated this was a temporary pause and gives the administration time to review agency programs and “determine the best uses of the funding for those programs consistent with the law and the President’s priorities.”

Later, the OMB rescinded the memo, but the White House press secretary said other freezes tied to executive orders issued by Trump remained in effect. This has led to more confusion, uncertainty, and delays including research.

“Money not going into research funds means money not going into clinical trials, which are not going into discovering therapies that are ultimately going into patients. And with the sort of wide pauses and suspension of some of the work of our federal health agencies in NIH, CDC, and FDA—that's what I think of more than anything else,” Gallagher said. He notes a large portion of the university funding for research comes from those aforementioned government agencies.

Much remains to be seen how this will all play out. The hearings for Robert F. Kennedy Jr for the Health and Human Services Secretary position were this week and a vote for his confirmation has not taken place yet. If he does become secretary, this could also have long term effects on public health policy including vaccines. 

“I think most pauses will be lifted at some point, and what comes off on the other side of that is something we don't know. It could be stipulations, and what can be researched,” Gallagher said.




References
1.Withdrawing the United States From the World Health Organization. White House executive order. The White House. January 20, 2025. Accessed January 31, 2025. https://www.whitehouse.gov/presidential-actions/2025/01/withdrawing-the-united-states-from-the-worldhealth-organization/
2.CDC ordered to stop working with WHO immediately, upending expectations of an extended withdrawal. WHYY. January 27, 2025. Accessed January 31, 2025. 

https://whyy.org/articles/trump-cdc-who-public-health/


3. Trump Spending Freezes Sow Confusion Among Researchers. AIP. January 30, 2025. Accessed January 31, 2025.
https://ww2.aip.org/fyi/trump-spending-freezes-sow-confusion-among-researchers

This is the second in a series looking at the intersection of government and public health. In this segment, Contagion Editor-in-Chief Jason Gallagher, FCCP, FIDP, FIDSA, BCPS, discusses the WHO pullout, and the pauses on federal communication and research grants. 

This is the first in a series looking at the intersection of the federal government and public health and how the former greatly influences the latter.



Until 2001, the only biocontainment unit in the country was located at the US Army Medical Research Institute for Infectious Diseases (USAMRIID) at Fort Detrick, Maryland. But then in 2001 2 seminal events led to the realization that the United States was woefully unprepared for a large biological event. The first occurred in June after a tabletop exercise conducted at the Johns Hopkins Center for Health Security called 

Involving active and former government personnel from all political viewpoints, the exercise simulated a fictional scenario involving a variola major (smallpox) attack in the US. The findings were presented to President George W. Bush, and it found that because there was no surge capability in any sector of the US healthcare system, a biologic attack could and would threaten national security.

 Three months later and just 1 week after the terrorist attacks on September 11, letters laced with 

Biocontainment, including the most recent threat of highly pathogenic avian influenza, demands we continue to finance research, and continue cooperation with important organizations like the WHO. 

Aileen Ahiskali, PharmD

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