The Power of We.

"The Power of We" is a personal tribute to the individuals and organizations that collaborated in the discovery and advancement of knowledge of the hantaviruses following the original isolation of Hantaan virus by Ho Wang Lee. It focuses on the work done primarily at the United States Army Medical Research Institute of Infectious Diseases during the decade of the 1980s under the leadership of Joel Dalrymple, who worked in close partnership with Ho Wang Lee. These early studies helped define the global distribution of Seoul virus and provided seminal information on its maintenance and transmission among urban rats. Other collaborations involved partners in Europe, Asia, and Latin America and resulted in the isolation of novel hantaviruses, a better understanding of their global distribution, and validation of diagnostics and therapeutic interventions for treatment of human diseases. By working in partnership, scientists from around the world made critical discoveries that led to a better understanding of the hantaviruses. "The Power of We" demonstrates that we all benefit when we work together with a shared vision, a common commitment to excellence, and mutual respect.

Technology Advances, High-Risk Research, and a Safe Way Forward.

The human and economic toll of the coronavirus disease 2019 (COVID-19) pandemic and the unknowns regarding the origins of the virus, with a backdrop of enormous advances in technologies and human understanding of molecular virology, have raised global concerns about the safety of the legitimate infectious disease research enterprise. We acknowledge the safety and security risks resulting from the broad availability of tools and knowledge, tools and knowledge that can be exploited equally for good or harm. The last 2 decades have shown us that the risks are real. They have also shown us that more traditional top-down regulations alone are not the answer. We encourage government to be thoughtful and nuanced in dealing with this significant challenge and to carefully consider human factors and the important role of organizational-level leadership before simply layering an additional bureaucratic burden on the enterprise without understanding value and cost.

A Quarter Century of Emerging Infectious Diseases - Where Have We Been and Where Are We Going?

A quarter century ago the landmark report from the U. S. National Academies of Sciences, Engineering, and Medicine entitled "Emerging Infections, Microbial Threats to Health in the United States" was released. This classic study captured the societal changes then underway in our rapidly growing world: The growth of the world's population and changing human behavior; the advances and globalization of technology and industry; the changes in economic development and land use; the dramatic increase in speed and frequency of international travel and commerce; the adaptation of microbes and the appearance of never before seen pathogens; and the breakdown of traditional public health measures. This societal evolution has only increased and the growing frequency of outbreaks foretold in the report has come to pass. Each new disaster has precipitated changes and adaptations in our global response to infectious diseases designed to reduce risks and avoid future outbreaks. We discuss these past events and how each led to change in an effort to mitigate future threats. We also look to the future to consider what challenges might lay ahead. CONCLUSION: Major outbreaks over the past quarter century validated the concept of emerging infectious diseases and led to improvements in global policies and national public health programs; however, there will likely always be new diseases and the threat of reemergence of diseases once thought controlled leading to a constant need for vigilance in public health preparedness.

The Role of a National Biocontainment Laboratory in Emergencies.

Over a decade ago, the National Institutes of Health awarded partial support for the construction and operation of 2 National Biocontainment Laboratories, with the condition that they would be available to assist in the event of public health emergencies-although how a biocontainment facility located on an academic campus might contribute was not defined. Here we offer examples of how one of these laboratories has contributed to a coordinated response to 2 recent international public health emergencies. Essential assets for success include highly trained and experienced staff, access to reference pathogens and reagents, cutting-edge knowledge of the field, appropriate biocontainment facilities, robust biosafety and biosecurity programs, and availability of modern instrumentation. The ability to marry the strengths of academia in basic and applied research with access to appropriate biocontainment facilities while drawing on a highly skilled cadre of experienced experts has proven extremely valuable in the response to recent national emergencies and will continue to do so in the future. Areas where additional planning and preparation are needed have also been identified through these experiences.

Personal Protective Equipment for Filovirus Epidemics: A Call for Better Evidence.

Personal protective equipment (PPE) is an important part of worker protection during filovirus outbreaks. The need to protect against a highly virulent fluid-borne pathogen in the tropical environment imposes a heat stress on the wearer that is itself a safety risk. No evidence supports the choice of PPE employed in recent outbreaks, and standard testing procedures employed by the protective garment industry do not well simulate filovirus exposure. Further research is needed to determine the appropriate PPE for filoviruses and the heat stress that it imposes.

Review and assessment of the American Society of Tropical Medicine and Hygiene travel awards program, 1991-2010.

During 1991-2010, 456 persons from 62 countries were provided financial support to attend the annual meeting of the American Society of Tropical Medicine and Hygiene. Winners came from 17 African, 16 Asia-Pacific, 14 Latin American and Caribbean, and 13 European and Middle Eastern countries, and from Canada and the United States. Virtually equal numbers of awards were offered to women and men. Winners were selected from U.S. academic centers (30%), foreign universities (26%), international centers, institutes or research units (30%), and approximately 5% from U.S. government agencies. Almost all winners (73 of 76, 96%) had scientific publications subsequent to receiving the travel award. Less than 10% of award winners continued their membership in the Society after their one-year complementary membership. Winners indicated that the travel awards program facilitated international exchange and fostered collaborations between Society members and international scientists.

Framework for leadership and training of Biosafety Level 4 laboratory workers.

Construction of several new Biosafety Level 4 (BSL-4) laboratories and expansion of existing operations have created an increased international demand for well-trained staff and facility leaders. Directors of most North American BSL-4 laboratories met and agreed upon a framework for leadership and training of biocontainment research and operations staff. They agreed on essential preparation and training that includes theoretical consideration of biocontainment principles, practical hands-on training, and mentored on-the-job experiences relevant to positional responsibilities as essential preparation before a person's independent access to a BSL-4 facility. They also agreed that the BSL-4 laboratory director is the key person most responsible for ensuring that staff members are appropriately prepared for BSL-4 operations. Although standardized certification of training does not formally exist, the directors agreed that facility-specific, time-limited documentation to recognize specific skills and experiences of trained persons is needed.