WHO blunders

Yesterday, the World Health Organization convened a meeting of 22 international flu and public health experts to debate the issue of whether and how to release new findings on possibly highly transmissible forms of the H5N1 flu virus. This is the flu strain that is carried by millions of birds in Asia but very rarely infects humans – but is highly lethal when it does so. Until recently, that was the status quo, with experts worrying that at any moment a critical mutation might occur that would allow H5N1 to become much more infectious to humans, and thus cause a monumentally disastrous pandemic resembling the 1918 “Spanish” flu (see my Chap. 1). But now, researchers at Erasmus Medical Center in Rotterdam, the Netherlands, and at the University of Wisconsin-Madison have mutated H5N1 so that can infect and be transmitted between mammals (ferrets) in the lab. These results were to be published by Science and Nature, but the journals have help up publication until some consensus could be reached on how to handle the actual sequence data. One idea was to redact the critical part of the data so readers (and potential terrorists) would not be shown how to make such viruses themselves. The next was to then allow authentic researchers, whose labs had high security facilities, to see the missing data. But now the group convened by WHO has argued (with the US representative dissenting) that the articles should be published in full, in order that all interested scientists can work on these viruses. One positive outcome of such research, it is argued, would be the development of an effective anti-H5N1 vaccines. Of course, such vaccines represent the holy grail of this field. However, as everyone knows, despite years of trying, we have yet to see the implementation of a pan-flu vaccine that can work against the minor variations that occur each year. Thus, we must get vaccinated each year with a new vaccine specific to the new seasonal virus. This raises skepticism that a pan-H5N1 vaccine will be developed quickly.

But what seems to me to be the most dangerous aspect of this new work is the likelihood of leakage of the new virus from the lab into the public domain. First, I have no idea if any terrorists have the capability of making the appropriate mutations in H5N1 that make it transmissible between humans. However, we can be sure that when the sequences and methods are published, such folks will attempt it, and it also seems highly likely that this will occur in many cases in less than high security labs. Second, even in our own high security facilities in the US, experience tells us that accidents do indeed happen, and at surprisingly high frequences. A worker who is inadvertently infected could walk out of the lab and start the pandemic. We also know that mentally unstable people can and do release highly infections agents aimed at personal or perceived enemies. This new H5N1 strain has the potential to be far, far more disastrous than anthrax, for instance, because it would be transmissible.

I my view, the public should rise up against the publication of these papers, and scientists should lead the way in spreading the word. [A caveat to this scare is that the successful transmission between ferrets does not necessarily mean that the mutant virus will also be transmitted between humans. While ferrets are considered the best model for this work, there have been failures in translating findings from ferrets to humans in the past.]

Some agreement in Feb 9 Nature editorial: “The mutant flu studies offer no serious immediate application in vaccine research”…”the risks seem to outweigh the public health benefits, at least in the short term..”


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