The risks to world health from research to make an extraordinarily lethal avian flu virus contagious in humans have finally caught everyone's attention after months of warnings from us (Lynn Klotz*) and many other experts.
The Atlantic online (Feb. 16) features this question: Shouldn't regular citizens be able to weigh in on whether scientists are allowed to play with a virus that could kill a third of the population? Writer Pagan Kennedy's answer, summarized in the headline: Good luck.
Unfortunately, that feared virus may already exist. Two forms of the virus residing in two laboratories, one in the Netherlands and one in Wisconsin, may be highly contagious and highly deadly in humans, but we have evidence only from a good animal model for influenza viruses. We'll never know if it would be as deadly in humans simply because we cannot infect humans to get the proof.
Those who have been sounding the alarm are among the world leaders in molecular biology, microbiology, virology, public health and microbial genetics. Dr. Paul Keim was quoted in the journal Science in November: "I can't think of another pathogenic organism that is as scary as this one.... I don't think anthrax is scary at all compared to this."
The anthrax connection: Keim is the molecular geneticist who traced the strain used in the 2001 anthrax-letter attack that killed five people, locating it at the U.S. Army Medical Research Institute of Infectious Diseases at Ft. Detrick, Md. More importantly, he is now chair of the National Science Advisory Board for Biosecurity. The NSABB persuaded the researchers working on the H5N1 virus to remove key details before publishing their current results, and the researchers agreed to stop further work for at least 60 days.
Saturday's New York Times (Feb. 18) features a Page 1 story announcing that the World Health Organization is recommending that full details of the work be published, contrary to the NSABB recommendations. Publication is not the issue. The research itself should only resume if and when its benefit is clearly defined, and then only in BSL4 laboratories - the highest bio-security level - with the further requirement that workers with live virus undergo a quarantine period to assure they take nothing out with them.
Meanwhile, during that breathing period, we will try to explain the hazards of such research, the possible benefits that are driving it to begin with, and better ways to conduct investigations. The overall goals of the researchers are noble ones. They are hoping to protect us against the very real danger that naturally occurring H5N1 influenza virus, which now kills entire bird flocks and is quite lethal in humans, could mutate in ways that would also make it contagious in humans. But this is not the way to go about it.
Doesn't this bird flu kill people now?
Yes. And it may have a mortality rate of nearly 60%, higher than smallpox and any of the strains in the worst flu outbreaks known. But people cannot catch it from one another except under very unusual circumstances. The people to catch H5N1 flu so far tended chickens or worked with poultry closely enough that they were constantly exposed to the virus. By contrast, the so-called 1918 flu virus that killed millions in the United States and a total of 40 million around the world was incredibly contagious among humans. But it killed only about 2% of those infected. Imagine a new virus that combined the lethality of the H5N1 flu with the contagiousness of the 1918 pandemic strain. That is the scenario we may now be facing.
Soon to come:
What other lab-created risks are out there? How can we prevent them?
* Lynn Klotz was the US country researcher for the BioWeapons Monitor 2011 report where earlier attempts to make H5N1 Asian bird flu more pathogenic were highlighted. See p129
Lynn C. Klotz and Edward J. Sylvester are authors of Breeding Bio Insecurity: How U.S. Biodefense Is Exporting Fear, Globalizing Risk, and Making Us All Less Secure, University of Chicago Press, 2009.