This document discusses global health security threats from biological sources. It outlines emerging infectious diseases, antimicrobial resistance, and other biological dangers such as bioterrorism and dual-use research. Emerging diseases are spreading more rapidly due to factors like population growth, travel, and climate change. Antimicrobial resistance has risen dangerously as misuse of antibiotics grows. Strong detection, prevention and response are needed worldwide to address biological threats that ignore borders. International cooperation is essential for global health security.

1. Global Health Security
Dr. Nawfal Hussein
nawfal.aldujaili@uokufa.edu.iq
April 04 2020
1
Biological Threats Don’t Respect National Borders

2. Outlines
• Biological threats
• Emerging Infectious disease (EID)
• One health
• Antimicrobial Resistance (AMR)
• Health care waste
• Bioterrorism
• Dual Use Research of Concern (DURC)
• Genome editing
• Synthetic Biology
• Biosecurity 2

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6. World 100 years ago and Now
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100 years ago Now
Population 1.5 Billion 7 Billion
Isolated communities Megacities are incubators
55 % in cities, 1 in 7 in slums
Minimum travel 30,000 flights/day
Most people lives in 100 miles radius Climate change, Civil unrest

7. Environmental Pressures
• 30 % of recent outbreaks of Ebola, Zika and Nipah viruses linked to tree-
cover loss
• Migration and dispersal of birds due to habitat degradation could expose
populations to novel pathogens including avian, malaria, new parasites,
and viruses.
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8. Emerging Infectious Disease (EID)
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 Emerging infections Infectious diseases whose incidence
in humans has increased in the past 2 decades or threatens
to increase in the near future These diseases, which respect
no national boundaries, include:
New infections (resulting from changes or evolution of existing organisms)
Infections spreading to new geographic areas or populations
Previously unrecognized infections in areas undergoing
ecologic transformation
 Old infections reemerging as a result of antimicrobial
resistance in known agents or breakdowns in public health
measures

9. Emerging Species in Taxonomic Division
o 1400 species of infectious organisms , pathogenic to humans
o 175 pathogenic species with emerging diseases
o75% were zoonotic
• 44 % Viruses or prions
• 30 % Bacteria or rickettsia
• 11 % Protozoa
• 9 % Fungi
• 6 % Helminths
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10. Death tolls
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12. Modes of transmission of infectious agents
 Direct (infective form directly from reservoir or host)
• Direct contact
• Direct spread of droplets
• Direct exposure to an infectious agent in the environment
• Bite
• Transplacental/perinatal
 Indirect (infective form indirectly from reservoir or infected host)
• Biological (Biological vector and Intermediate host)
• Mechanical( Mechanical vector, Vehicle and , Airborne)
Pathogens transmitted by
• 53%Direct contact ,47%Indirect contact, 28%Vectors, 6% unknown
• HIV, influenza A, Ebola and SARS (rare events animal-human-human)
• rabies and other lyssa, Nipah, West Nile, Hantavirus (repeated episodes of direct animal-to-human transmission or repeated
vector mediated animal-to-human transmission
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animals pathogens
evolve to cause
disease to humans

14. Why EID
• Increased frequency and speed
of both local and international travel
1.8 billion international annual tourist
arrivals in 2030.
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17. Global Climate Change affect EID
Global temperature increase by 0.3–4.8ºC
Shifting the vector's geographic range, Increasing reproductive
and biting rates
• Shortening the pathogen incubation period.
• Human migration and damage to health infrastructures
• Human susceptibility to infections
• Incidence of mosquito-borne diseases, including malaria and
dengue …..
Climate-related increases in sea surface temperature and sea
level can lead to higher incidence of water-borne infectious and
toxin-related illnesses, such as cholera and shellfish poisoning.
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18. Preparedness Actions for EID
• Surveillance
• Robust outbreak investigation practices
• Transmission prevention through containment and control
measures
• Delivery of medical countermeasures
• Public messaging
• Recovery to a “new normal”
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19. Deaths attributable to AMR annually, and by 2050
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20. Antimicrobial Resistance (AMR)
• AMR: Microorganisms (including bacteria, viruses, fungi, and parasites)
resistant to antimicrobials (such as antibiotics, antivirals, antifungal drugs, and
antiparasitic drugs).
• Superbugs: Bacteria develop resistant to majority of antibiotics commonly
used today.
• Multidrug-resistant (MDR). Resistant to multiple antimicrobials. The new
bacteria takes 9 to 11 months to treat MDR tuberculosis.
• Extensively drug-resistant (XDR). Resistant to most antimicrobials.
susceptible to only one or two antimicrobial categories.
• Pandrug-resistant (PDR). Resistant to all antimicrobials.
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21. Antimicrobial Resistance (AMR)
• AMR is accelerated by the misuse and overuse of antibiotics, as well as
poor infection prevention and control.
• AMR that developed in your body may harm you, your families,
environment, other people , society as a whole.
• Each year more than 700,000 people die due to AMR . The death could
rise up to 10,000,000 people per year, by 2050.
• 200,000 to 250,000 tons of antimicrobials are consumed worldwide each
year. About 70% are consumed by animals and 30% are by humans.
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22. AMR
• 1980 : Infectious diseases are under control antibiotic are magic pills .
• 1990 : Salmonella typhi ,diagnostic difficulty, AMR , difficult Treatment .
• Led three TB outbreak investigations in US All resistant strains.
• XDR Typhoid .7000 culture confirmed cases, 40,000 XDR cases.
• Candida auris :Resistant fungal disease in 2009 .High fatality rate.
• 2016 : XDR Typhoid, Hyderabad . Resistant to five classes of antibiotics,
More than 7000 culture confirmed cases 22

25. Alternative products to treat infections
• Phage therapy
• Bacterial therapy (Probiotics. Prebiotics .synbiotics and FMT)
• Peptides
• Antibodies
• Immune stimulation
• Lysins
• Nanobiotechnology

26. One Health
worldwide collaborative efforts of multiple stakeholders to achieve optimal and
sustainable well-beings of human beings, livestock, poultry, wildlife and environment.
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Conceptualization
of
a
One
Health
project.

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29. Health care waste
Health care waste includes all the waste generated within
health care facilities, research centers and laboratories
related to medical procedures.
Figure Typical waste
composition in
health care facilities
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30. Risk Associated with Biohazardous Waste
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• Contaminated drinking water
• Pollutants from inadequate incineration
• Secondary transmission to others
General Public
• Affect livestock, crops and food chain
• Contaminate soil
Environment
• Potential for direct or indirect exposure through
various routes of transmission
Biohazardous
Waste Handlers

31. Waste Treatment Technologies
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Waste Treatment
Technologies
Thermal
Biological
Chemical
Irradiation

32. Bioterrorism
Agroterrorism the deliberate introduction of animal or plant pests (eg,
bacteria, viruses, fungi) with generating fear, causing economic damage,
and/or undermining social stability
Biological warfare a specialized type of warfare involving the use of biological
agents conducted by a government against a target (human, agriculture, or
infrastructure)
Bioterrorism: the threat or use of a biological agent (or toxin) against humans,
animals, or plants by individuals or groups motivated by political, religious,
ecological,……
Bioterrorism aims to create casualties, terror, societal disruption, or economic
loss, inspired by ideological, religious or political beliefs. bioterrorism cause
economic losses by infecting livestock or crops, or contaminating buildings.
Biocrime: the threat or use of a biological agent for murder, extortion, or
revenge

33. Advantages and Disadvantages of Using Biologicals
• Advantages
• Small quantities and cheap may have dramatic effects.
• Difficulty in diagnosing index cases.
• Symptoms can mimic endemic, naturally occurring diseases.
• Disadvantages
• Biological agents may affect the health of the aggressor.
• Weather conditions directly affect dispersion.
• Weather conditions lessen the survivability of some organisms.
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34. History of Biological Warfare
• 1356 siege of Kaffa, Tartars catapulted cadavers of plague
victims over city walls
• 1710 :Russian attack on Swedish city of Reval, used plague
corpses in attack
• 17th: British army distributed blankets infected with smallpox
virus to native Americans
• 2001—anthrax attacks in the United States

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36. Dual Use Research of Concern (DURC)
• DURC :misuse of life sciences research conducted for legitimate
scientific purposes.
• DURC“Life sciences research that, based on understanding, can provide
knowledge, information, products, or technologies could be directly
misapplied to pose a threat with potential consequences to public health
and safety, agricultural crops and other plants, animals, the environment,
materiel, or national security”
• 2001 Ron Jackson of Australian National University found that inserting
an Interleukin 4 gene in mousepox killed the animals (including many that
had been vaccinated for mousepox). They had been trying to create a
vaccine to stimulate antibodies against mouse eggs to make the animals
infertile. The mousepox virus as a vector to carry egg proteins to trigger
an immune response, and the IL-4 was to boost antibody production 36

37. DURC ?
37
Public
good
Misused
for
harm

38. Genome editing
• Technique enables precise modification of the nucleic acid sequences
• overproduction intended metabolites including green chemicals and fuels.
• To this end, genome editing and expression control are performed by
recruiting a series of genetic tools, including
• Antisense RNA
• RNA interference (RNAi)
• transposon mutagenesis
• RecA ,Red-based homologous recombination
• zinc finger nucleases (ZFN)
• Transcription activator-like effector nucleases (TALEN)
• CRISPR-Cas9 technology.
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39. CRISPR Technology
• CRISPR adaptive immune systems derived from the immune systems in
bacteria and archaea against foreign nucleic acids,phages and plasmids.
• The Cas9 endonuclease can drive DNA binding and cleavage through an
engineered single guide RNA (sgRNA) sequence .
• Editing genes can mean removing or replacing an existing gene,
switching a gene on or off, or inserting a new gene altogether
• Researchers order the sequence of guide RNA to include a part of the
gene they're interested in, plus the Cas binding sequence, mix it with the
Cas protein to suit the job and they're ready to go
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41. Twin girls altered DNA to protects from HIV
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42. Synthetic Biology
• Synthetic biology : design and construction of new biological parts, devices and
systems and the re-design of existing biological systems.
• The ability to synthesize any genomic sequence both naturally occurring and artificial
• Transform bacteria and viruses with selected genes, recreate known but difficult to
attain pathogens (including extinct ancient pathogens), and even create novel
microbial genomes is a growing reality.
 Studying genes, altering cell lines to study diseases, generating therapeutic solutions,
and bioenergy
• Generate a microorganism to use as a biological weapon or could create unintentional
consequences of an accidental release. 42

43. Making Microorganism
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Technique Example
Transferring genes B.anthracis to E.coli
Gene shuffling rearranging gene
sequence
Removing part of a gene in Ebola (more
toxic)
Synthetic microbes gene sequences as
building blocks and splicing together
• Live polio virus (synthetic
oligonucleotides)
• Adding IL-4 to mousepox genome,
virus was able to kill mice vaccinated
against mousepox
Hybrid viruses (recombining related
strains )
Dengatitis virus (HBC & dengue to find
a vaccine for HBC)

44. What are the Solutions for Biological threats
Health Security
Biosecurity
Biosafety
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45. Detection Technologies
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