Biosecurity | MacIntyre Research Lab

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Raina MacIntyre has a research track record in health security and risk analysis methods for biosecurity, with a focus on bioterrorism recognition. She is working on rapid epidemic intelligence methods for outbreak surveillance. She has pioneered concepts such as recognition of unnatural epidemics. Developing new tools and methods for detection of unnatural epidemics is a major area of current research within her program. Asking the question “natural or unnatural” is the first step to recognising bioterrorism, and is absent in public health culture. Toward changing thinking in this area, she conceived and led the creation of a groundbreaking course at UNSW, Bioterrorism and Health Intelligence. She has published on dual-use research of concern, and the lack of global preparedness for dealing with new scientific advances such as the gene editing tool CRISPR Cas9.

Her research is underpinned by extensive field outbreak investigation experience. She is a graduate of the only Australian Field Epidemiology Training program, the MAE at ANU, and has extensive experience in shoe-leather epidemiology of infectious diseases outbreaks including influenza, meningococcal disease, clostridium perfringens, hepatitis A, legionella, mycoplasma, pertussis and gastroenteritis to name a few. Her in-depth understanding of the science of outbreak investigation draws from this experience combined with her academic training through a Masters and PhD in Epidemiology. Her passion for field epidemiology led her to co-found the ARM network for Australian outbreak response. She does research on the transmission dynamics and prevention of infectious diseases, particularly respiratory pathogens such as influenza, tuberculosis and other vaccine-preventable infections. She has also done research on using risk-analysis methods for analysing emerging infectious diseases outbreaks such as Ebola and MERS-CoV. She leads an open source epidemic observatory, EpiWatch, which uses artificial intelligence to detect epidemic signals from open source data, which has a focus on detecting unusual or abberant outbreaks. She led a NHMRC Centre for Research Excellence in Epidemic Response from 2016-2020.

She won many career awards including the Sir Henry Wellcome Medal and Prize, from the Association of Military Surgeons of the United States in 2007 for her work on a risk-priority scoring system for category A bioterrorism agents; and the highest national award in infectious diseases, the Frank Fenner Award for Research in Infectious Diseases in 2003. She is interested in the risk posed by convergence of technologies in health security.

She has over 400 peer reviewed publications, sits on editorial boards for BMJ Open, Epidemiology and Infection and Vaccine, and has been on many national and international expert committees in her field.

In 2018 and 2019 we held pandemic simulation in Australia, Bangladesh and the United States. This simulation dealt with all the issues seen during COVID-19 - surveillance and case detection, mass quarantine, travel bans, stranded cruise ships and more. We offer the Unknown Biothreat Simulation as a self-paced online exercise.

Selected publications

MacIntyre CR; Heslop DJ; Nguyen P; Adam D; Trent M; Gerber BJ, 2022, 'Pacific Eclipse – A tabletop exercise on smallpox pandemic response', Vaccine, vol. 40, pp. 2478 - 2483, http://dx.doi.org/10.1016/j.vaccine.2021.10.081

MacIntyre CR, 2022, 'Special Issue - Pacific Eclipse', Vaccine, vol. 40, pp. 2473, http://dx.doi.org/10.1016/j.vaccine.2022.03.007

Chawla D; Trent M; Moa A; Stone H; MacIntyre R, 2021, 'An analysis of COVID-19 outbreaks in schools in South and Southwestern United States using open-source data', Global Biosecurity, vol. 3, http://dx.doi.org/10.31646/gbio.132

Li X; Wang Q; Ding P; Cha Y; Mao Y; Ding C; Gu W; Wang Y; Ying B; Zhao X; Pan L; Li Y; Chang J; Meng C; Zhou J; Tang Z; Sun R; Deng F; Wang C; Li L; Wang J; MacIntyre CR; Wu Z; Feng Z; Tang S; Xu D, 2021, 'Risk factors and on-site simulation of environmental transmission of SARS-CoV-2 in the largest wholesale market of Beijing, China', Science of the Total Environment, vol. 778, http://dx.doi.org/10.1016/j.scitotenv.2021.146040

Mahmood T; Javed M; MacIntyre R; Moa A, 2021, 'Early signs of COVID-19 in Pakistan', Global Biosecurity, vol. 3, http://dx.doi.org/10.31646/gbio.87

Luo Z; Zhang Y; Zheng Y; Macintyre CR; Liang Y; Wang Q; Ma Y, 2021, 'Prevention of SARS-CoV-2 transmission from international arrivals: Xiaotangshan designated hospital, China', Bulletin of the World Health Organization, vol. 99, pp. 374 - 380, http://dx.doi.org/10.2471/BLT.20.265918

Lesmanawati DAS; Adam DC; Hooshmand E; Moa A; Kunasekaran MP; MacIntyre CR, 2021, 'The global epidemiology of Hepatitis A outbreaks 2016-2018 and the utility of EpiWATCH as a rapid epidemic intelligence service', Global Biosecurity, vol. 3, http://dx.doi.org/10.31646/gbio.100

Costantino V, Kunasekaran M, MacIntyre CR. Modelling of optimal vaccination strategies in response to a bioterrorism associated smallpox outbreak. Hum Vaccin Immunother. 2021 Mar 4;17(3):738-746.

Mohanty B, Costantino V, Narain J, Chughtai AA, Das A, MacIntyre CR. Modelling the impact of a smallpox attack in India and influence of disease control measures. BMJ Open. 2020 Dec 13;10(12):

Chen X, Bahl P, de Silva C, Heslop D, Doolan C, Lim S, MacIntyre CR. Systematic Review and Evaluation of Mathematical Attack Models of Human Inhalational Anthrax for Supporting Public Health Decision Making and Response. Prehosp Disaster Med. 2020 Aug;35(4):412-419. doi: 10.1017/S1049023X20000734. Epub 2020 Jun 4. PMID: 32495728.

MacIntyre CR, 2020, 'Reevaluating the risk of smallpox reemergence', Military Medicine, vol. 185, pp. E952 - E957, http://dx.doi.org/10.1093/milmed/usaa084

Chen X, Chughtai AA, MacIntyre CR. Application of a Risk Analysis Tool to Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Outbreak in Saudi Arabia. Risk Anal. 2020 May;40(5):915-925.

MacIntyre CR, Adam DC, Turner R, Chughtai AA, Engells T. Public awareness, acceptability and risk perception about infectious diseases dual-use research of concern: a cross-sectional survey. BMJ Open. 2020 Jan 6;10(1)

Offner, Kim; Sitnikova, Elena; Joiner, Keith; MacIntyre, Raina. Towards understanding cybersecurity capability in Australian healthcare organisations: A systematic review of recent trends, threats and mitigation. Intelligence and National Security, April 22 2020. https://doi.org/10.1080/02684527.2020.1752459

MacIntyre CR, Costantino V, Kunasekaran MP. Health system capacity in Sydney, Australia in the event of a biological attack with smallpox. PLoS ONE. 2019;14(6):e0217704-e.

Kunasekaran, Mohana Priya; Chen, Xin; Costantino, Valentina; Chughtai, Abrar Ahmad; MacIntyre, Chandini Raina. Evidence for Residual Immunity to Smallpox After Vaccination and Implications for Re-emergence . Mil Med. 01 Aug 2019. doi: 10.1093/milmed/usz181

Chen X, Chughtai AA, MacIntyre CR. Recalibration of the Grunow Finke Assessment Tool to improve performance in detecting unnatural epidemics. Risk Analysis. 01 Jan 2019. doi: 10.1111/risa.13255

dam DC, Scotch M, MacIntyre CR. Bayesian Phylogeography and Pathogenic Characterization of Smallpox Based on HA, ATI, and CrmB Genes. Mol Biol Evol. 2018 Nov 1;35(11):2607-2617.

Lesmanawati DAS, Veenstra P, Moa A, Adam DC, MacIntyre CR. A rapid risk analysis tool to prioritise response to infectious disease outbreaks. BMJ Glob Health. 2020 Jun;5(6)

Chen X, Adam DC, Chughtai AA, Stelzer-Braid S, Scotch M, MacIntyre CR. The Phylogeography of MERS-CoV in Hospital Outbreak-Associated Cases Compared to Sporadic Cases in Saudi Arabia. Viruses. 2020 May 14;12(5):540.

Joshi A, Sparks R, Karimi S, Yan SJ, Chughtai AA, Paris C, MacIntyre CR. Automated monitoring of tweets for early detection of the 2014 Ebola epidemic. PLoS One. 2020 Mar 17;15(3)

MacIntyre, C.R., Costantino, V., Mohanty, B., Nand, D., Kunasekaran, M.P. and Heslop, D. Epidemic size, duration and vaccine stockpiling following a large-scale attack with smallpox. Global Biosecurity 2019, 1(1). doi: http://doi.org/10.31646/gbio.13

Heslop, D.J. and MacIntyre, C.R. Germ line genome editing and the emerging struggle for supremacy in the Chemical, Biological and Radiological (CBR) balance of power. Global Biosecurity, 2019; 1(1).

Armstrong J; Adam D; Kunasekaran M; MacIntyre R; Nand D; Heslop D, 2019, 'Themes and correlations of participant experience and evaluation of an interactive bioterrorism release exercise – a mixed methods study', Journal of Global Biosecurity, vol. 1

David H; MacIntyre R, 2019, 'Germ line genome editing and the emerging struggle for supremacy in the Chemical, Biological and Radiological (CBR) balance of power', Global Biosecurity, vol. 1, pp. 169 - 173, https://jglobalbiosecurity.com/articles/18/

MacIntyre R;Heslop D;Nand D;Schramm C;Butel M;Rawlinson W;Baker M;Kiedrzynski T;Nelson C;Fotualii L;Yeo K;Elsgaard J;Fonua L;Lane M, 2019, 'Exercise Mataika: White Paper on response to a smallpox bioterrorism release in the Pacific', Journal of Global Biosecurity

MacIntyre CR, Valentina C, Xin C, et al. Influence of Population Immunosuppression and Past Vaccination on Smallpox Reemergence. Emerging Infectious Disease journal. 2018;24(4).

Raina MacIntyre, C., Engells, T.E., Scotch, M. et al. Converging and emerging threats to health security, Environ Syst Decis (2018) 38: 198. https://doi.org/10.1007/s10669-017-9667-0

Moa A, Muscatello D, Chughtai A, Chen X, MacIntyre CR. Flucast: A Real-Time Tool to Predict Severity of an Influenza Season. JMIR Public Health Surveill. 2019 Jul 23;5(3):e11780.

Njoto EN, Scotch M, Bui CM, Adam DC, Chughtai AA, Macintyre CR, 2018, 'Phylogeography of H5N1 avian influenza virus in Indonesia', Transboundary and Emerging Diseases, http://dx.doi.org/10.1111/tbed.12883

Valentina Costantino, Mohana P Kunasekaran, Abrar A Chughtai, Chandini R MacIntyre; How Valid Are Assumptions About Re-emerging Smallpox? A Systematic Review of Parameters Used in Smallpox Mathematical Models, Military Medicine, https://doi.org/10.1093/milmed/usx092

MacIntyre CR;Dyda A;Bui CM;Chughtai AA, 2018, 'Rolling epidemic of Legionnaires' disease outbreaks in small geographic areas article', Emerging Microbes and Infections, vol. 7, http://dx.doi.org/10.1038/s41426-018-0051-z

Pan Y, Q Wang, P Yang, L Zhang, S Wu, Y Zhang, Y Sun, W Duan, C Ma, M Zhang, X Zhang, and C R MacIntyre (2017) Influenza vaccination in preventing outbreaks in schools: A long-term ecological overview Vaccine

Ralf Itzwerth, Aye Moa, C. Raina MacIntyre. Australia’s inﬂuenza pandemic preparedness plans: an analysis J Public Health Pol (2017)

MacIntyre CR, Bui CM. Pandemics, public health emergencies and antimicrobial resistance - putting the threat in an epidemiologic and risk analysis context. Archives of Public Health. 2017;75(1):54.

Ajisegiri W S, Chughtai A A, and MacIntyre C R. (2017), A Risk Analysis Approach to Prioritizing Epidemics: Ebola Virus Disease in West Africa as a Case Study. Risk Analysis. doi:10.1111/risa.12876

Heslop DJ, Chughtai AA, Bui CM, MacIntyre CR. Publicly available software tools for decision-makers during an emergent epidemic—Systematic evaluation of utility and usability. June 2017, Epidemics. Full text

Muscatello DJ;Chughtai AA;Heywood A;Gardner LM;Heslop DJ;MacIntyre CR, 2017, 'Translation of Real-Time Infectious Disease Modeling into Routine Public Health Practice.', Emerg Infect Dis, vol. 23, http://dx.doi.org/10.3201/eid2305.161720

Wong ZS Y;Bui CM;Chughtai AA;Macintyre CR, 2017, 'A systematic review of early modelling studies of Ebola virus disease in West Africa - CORRIGENDUM.', Epidemiol Infect, pp. 1, http://dx.doi.org/10.1017/S0950268817000759

Narasimhan P;MacIntyre CR;Mathai D;Wood J, 2017, 'High rates of latent TB infection in contacts and the wider community in South India.', Trans R Soc Trop Med Hyg, pp. 1 - 7, http://dx.doi.org/10.1093/trstmh/trx016

Bui CM;Gardner L;MacIntyre R;Sarkar S, 2017, 'Influenza A H5N1 and H7N9 in China: A spatial risk analysis', PLoS ONE, vol. 12, http://dx.doi.org/10.1371/journal.pone.0174980

Bui CM;Chughtai AA;Adam DC;MacIntyre CR, 2017, 'An overview of the epidemiology and emergence of influenza A infection in humans over time', Archives of Public Health, vol. 75, http://dx.doi.org/10.1186/s13690-017-0182-z

Awadh A;Chughtai AA;Dyda A;Sheikh M;Heslop DJ;MacIntyre CR, 2017, 'Does Zika Virus Cause Microcephaly - Applying the Bradford Hill Viewpoints.', PLoS Curr, vol. 9, http://dx.doi.org/10.1371/currents.outbreaks.2fced6e886074f6db162a00d4940133b

Wong ZS Y;Bui CM;Chughtai AA;MacIntyre CR, 2017, 'A systematic review of early modelling studies of Ebola virus disease in West Africa', Epidemiology and Infection, vol. 145, pp. 1069 - 1094, http://dx.doi.org/10.1017/S0950268817000164

Moa AM;Muscatello DJ;Turner RM;MacIntyre CR, 2017, 'Epidemiology of influenza B in Australia: 2001-2014 influenza seasons', Influenza and other Respiratory Viruses, vol. 11, pp. 102 - 109, http://dx.doi.org/10.1111/irv.12432

Chughtai AA;Wang Q;Dung TC;Macintyre CR, 2017, 'The presence of fever in adults with influenza and other viral respiratory infections', Epidemiology and Infection, vol. 145, pp. 148 - 155, http://dx.doi.org/10.1017/S0950268816002181

Gardner LM;Chughtai AA;MacIntyre CR, 2016, 'Risk of global spread of Middle East respiratory syndrome coronavirus (MERS-CoV) via the air transport network', Journal of travel medicine, vol. 23, http://dx.doi.org/10.1093/jtm/taw063

MacIntyre RR;Engells TE, 2016, 'Current Biological Threats to Frontline Law Enforcement: From the Insider Threat to DIY Bio', Law Enforcement Executive Forum, vol. 16, pp. 25 - 37, ROS ID: 844583

Rosewell A;Effler P;Yapa C;Telfer B;Musto J;MacIntyre R, 2016, 'Ebola outbreak in west Africa: Considerations for strengthening Australia’s international health emergency response: It is time for a common vision and strategy for deploying australian expertise to i', Medical Journal of Australia, vol. 204, pp. 258 - 259, http://dx.doi.org/10.5694/mjal6.00018, ROS ID: 812753

Engells TE;MacIntyre R, 2016, 'Do it yourself biology - committed hobbyists or dangers to the public safety?', Journal of healthcare protection management : publication of the International Association for Hospital Security, vol. 32, pp. 39 - 54, http://dx.doi.org/10.13140/RG.2.1.4791.0006, ROS ID: 836088

MacIntyre CR, Chughtai AA. Recurrence and reinfection– a new paradigm for management of Ebola virus disease (EVD).Int J Infect Dis 2015; 43:58-61

MacIntyre, CR. Biopreparedness in the age of genetically engineered pathogens and open access science - an urgent need for a paradigm shift. Military Medicine, 2015; 180(9):943-9. doi: 10.7205/MILMED-D-14-00482.

*MacIntyre, C. R. Re-thinking the ethics of dual-use research of concern on transmissible pathogens. Environment, Systems and Decisions, 2015;35 (1):129-132. 10.1007/s10669-015-9534-9

*MacIntyre, CR, Travaglia, J. Heightened vulnerability, reduced oversight and ethical breaches on the Internet in the in West African Ebola epidemic. The American Journal of Bioethics, 2015.

Bui, C., A. Bethmont, A. A. Chughtai, L. Gardner, S. Sarkar, S. Hassan, H. Seale and C. R. MacIntyre, 2015: A Systematic Review of the Comparative Epidemiology of Avian and Human Influenza A H5N1 and H7N9 – Lessons and Unanswered Questions. Transboundary and Emerging Diseases, Jan 29, 2015. [Epub ahead of print]

MacIntyre CR, Chughtai AA, Seale H, Richards GA, Davidson PM. Uncertainty, risk analysis and change for Ebola personal protective equipment guidelines. Int J Nurs Stud. 2015; 52(5):899-903. doi: http://dx.doi.org/10.1016/j.ijnurstu.2014.12.001

*MacIntyre, C.R., Chughtai, A.A., Seale, H., Richards, G.A., Davidson, P.M. Respiratory protection for healthcare workers treating Ebola virus disease: are facemasks sufficient to meet occupational health and safety obligations? International Journal of Nursing Studies (2014), 51(11):1421-1426.

*MacIntyre CR. The discrepant epidemiology of Middle East respiratory syndrome coronavirus (MERS-CoV). Environ Syst Decis. 2014:1-8.

*GardnerLM and MacIntyreCR. Unanswered questions about the Middle East respiratory syndrome coronavirus (MERS-CoV). BMC Research Notes2014, 7:358 doi:10.1186/1756-0500-7-358

*Lauren M. Gardner, David Rey, Anita E. Heywood, Renin Toms, James Wood, S. Travis Waller, Mohamud Sheikh, C. Raina MacIntyre. A scenario-based evaluation of the Middle East respiratory syndrome coronavirus and the Hajj. Risk Analysis 2014;34(8):1391-400. .doi: 10.1111/risa.12253

*Polkinghorne BG, Massey, PD, Durrheim, DN, Byrnes, T, MacIntyre, CR. Prevention and surveillance of public health risks during extended mass gatherings in rural areas: The experience of the Tamworth Country Music Festival, Australia. Public Health. Volume 127, Issue 1, January 2013, Pages 32–38.

Li J, Seale H, Ray P, Wang Q, Yang P, Li S, Zhang Y and MacIntyre CR. E-Health Preparedness Assessment in the Context of an Influenza Pandemic: A Qualitative Study in China. British Medical Journal (BMJ) Open 2013 Mar 13;3(3). pii: e002293.

Li J, Ray P, Seale H, Bakshi A and MacIntyre CR. Tool for E-Health Preparedness Assessment in the Context of an Influenza Pandemic. International Journal of E-Health and Medical Communications, 2013. Volume 4, Issue 2, 16 pages.

Li J, Seale H, Ray P, Tariq A and MacIntyre CR. Are Organizations Prepared for E-Health Implementation to Respond to Pandemic Influenza? International Journal of Biomedical Engineering and Technology 2013; 11(3): 215-230.

*Muscatello DJ, Barr M, Thackway SV, MacIntyre CR. Epidemiology of influenza-like illness during pandemic (H1N1) 2009, New South Wales, Australia. Emerg Infect Dis 7(7):1240-7, 2011 Jul.

*Muscatello DJ. Cretikos MA. Macintyre CR. All-cause mortality during first wave of pandemic (H1N1) 2009, New South Wales, Australia, 2009. Emerging Infectious Diseases. 16(9):1396-402, 2010 Sep.

Peng Yang, Ying Deng, Xinghuo Pang, Weixian Shi, Xinyu Li, Lili Tian, Yi Zhang, Xiaoli Wang, Fang Huang, MacIntyre C. Raina and Quanyi Wang. Severe, critical and fatal cases of 2009 H1N1 influenza in China. Journal of Infection, 2010;61(4):277-83.

*Heywood AE. Watkins RE. Pattanasin S. Iamsirithaworn S. Nilvarangkul K. Macintyre CR. Self-reported symptoms of infection among travelers departing from Sydney and Bangkok airports. Journal of Travel Medicine. 17(4):243-9, 2010 Jul.

*Rosewell A, Wang B, Saksena NK, MacIntyre CR, Lindley R, Chiu C, Shineberg C, Clarke E, McPhie K, Ratnamohan KM, Booy R, Dwyer DE. Failure to Detect Oseltamivir Resistance by Rolling Circle Amplification and Sequencing Following Use in an Influenza A (H3N2) Outbreak at an Aged Care Facility. Journal of Antivirals & Antiretrovirals. 2009; 1; 56-61.

*Wood JG, McCaw J, Becker N, Nolan T, MacIntyre CR. Optimal dosing and dynamic distribution of vaccines in an influenza pandemic. American Journal Of Epidemiology. 169(12):1517-24, 2009 Jun 15.

*Seale H. Weston KM. Dwyer DE. Zhu M. Allchin L. Booy R. MacIntyre CR. The use of oseltamivir during an influenza B outbreak in a chronic care hospital. Influenza & Other Respiratory Viruses. 3(1):15-20, 2009 Jan.

Watkins RE, Cooke FC, Donovan RJ, Macintyre CR, Itzwerth R, Plant AJ. Influenza pandemic preparedness: motivation for protection among small and medium businesses in Australia. BMC Public Health. 2007 Jul 17;7(1):157.

*Wood JG, Zamani N, MacIntyre CR, Becker NG. Effects of internal border control on spread of pandemic influenza. Emerging Infectious Diseases 2007;13:1038-1045.

*MacIntyre CR, Secull A, Lane M, Plant AJ. Development of a risk priority score for category A bioterrorism agents as an aid for public health policy. Military Medicine. 171(7):589-94, 2006 Jul. Awarded the 2007 Sir Henry Wellcome Medal and Prize from the Association of Military Surgeons of the United States of America for this work.

*Thursky KA, Buising KL, Bak N, MacGregor L, Street AC, MacIntyre CR, Presneill JL, Cade JF, Brown GV. Reduction of broad spectrum antimicrobial use with computerised decision support in an ICU. International Journal for Quality in Health Care. 2006 Jun;18(3):224-31.

*MacIntyre CR. Empson M. Boardman C. Sindhusake D. Lokan J. Brown GV. Risk factors for colonization with vancomycin-resistant enterococci in a Melbourne hospital. Infection Control & Hospital Epidemiology. 22(10):624-9, 2001 October.