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Dangerous Acquaintances

Experiments to make some of the world's deadliest viruses more contagious to humans or to learn the secrets of those that already are contagious surge to the top of the news and slip downward with regularity. Now they are up again. This time it is work with the H5N1 avian flu virus, in particular a strain that is among the deadliest we face -- it kills close to 60% of its victims. To put this in context, the notorious 1918 flu pandemic killed 40 million to 50 million people worldwide with a different flu virus called H1N1, lethal to only about 2% of those infected.

But before we move on to the fierce debate over the risks to us all of working with deadly and highly contagious pathogens, we want to urge action that should not be debatable: We need to carry out this and other work under conditions that make experiments as safe as they can be. That would include debate before experiments are undertaken on whether and where experiments should be carried out. That is anything but the case now.

First, the backdrop to the news. The 1918 flu was extremely contagious, and that is the reason for its enormous toll. The newer, more lethal avian H5N1 does not spread easily from person to person, so more than half the victims still represents only about 500 human deaths. It can wipe out more than 90% of birds it infects, particularly those raised for food penned in close quarters. In addition to an untold number killed by the disease, hundreds of thousands more birds have been destroyed to prevent its spread.

Fear over the possibility that this avian H5N1flu could become highly contagious among humans like the 1918 flu or the 2009 "swine" flu is the reason H5N1 is back in the news. As reported on NPR's Nov. 17 "Morning Edition," Rotterdam scientist Ron Fouchier described in a conference how his group succeeded in making bird flu highly contagious among ferrets. Ferrets may serve as a good animal model for potential spread among humans..

Fouchier's team did so for the best possible motives, trying to understand what mutations in the wild virus would have to occur for it to spread as quickly among people as it does among birds. Knowing that, we might have warning of an impending epidemic to quarantine victims and rapidly develop a vaccine.

But creating so contagious a virus in the lab presents terrible risks in itself that far outweigh the benefits of understanding a transformation that may never occur in nature. The newly contagious, deadly virus could escape from the laboratory, as many pathogens have. It would be open to theft or copy-cat development by terrorist groups or rogue nations. For the resurrection of the 1918 flu virus and work on the deadly SARS virus, we argued these dangers and reported the objections of such biosecurity experts as Donald Henderson and Jack Woodall in Breeding Bio Insecurity.

Referring to the Fouchier experiments, Thomas Inglesby of the Center for for Biosecurity at the University of Pittsburgh Medical Center told "Morning Edition," "It's just a bad idea for scientists to turn a lethal virus into a lethal and highly contagious virus."

So what can be done?

• Institute an international system for deciding whether an experiment should be done at all. One carefully crafted system was developed by a group of biosecurity experts at the University of Maryland.

They proposed "that for less dangerous work, local oversight would suffice. But work judged of extreme concern - a few activities that, say, might result in pathogens "significantly more dangerous than currently exist" - would trigger international oversight."

• Carry out such highly dangerous experiments only with highest biosecurity.

• Do so only in a BSL-4 lab in a remote location, where an escape would pose the least risk to population areas.

• Train a full-time technical staff dedicated to work with highly dangerous pathogens to carry out experiments directed by research scientists who will not need to present in the BSL-4 facility.

• Require the lab staff to follow up extended work shifts with periods of quarantine before they head home to families, friends and neighbors.

The Obama administration has been moving in the right direction in improving research funding for emerging pandemic viruses such as H5N1, but much needs to be done to assure that efforts to prevent the next lethal outbreak don't inadvertently lead to it.

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