As far as scientists know, this virus cannot be found anywhere else on Earth; it was engineered into existence. This strain — once described by its creator as “probably one of the most dangerous viruses you can make” — has sparked one of the most inflamed bioethics debates in recent memory, raising anxieties over bioterrorism, scientific censorship and the prospect of a manmade pandemic.
The researchers who created the strain insist it will help protect the world from a serious pandemic threat. Others think it poses a danger to mankind and should be destroyed.
On Jan. 23, an announcement by a group of scientists sprung the virus from its yearlong lockup. Soon, it will return to a high-security laboratory for scientists to study.
But the question at the heart of the controversy lingers: could this strain exist outside the laboratory? In September 2011, an announcement at a flu conference in Malta sent a jolt through the room and around the world.
Dr. Ron Fouchier, a virologist with the Erasmus Medical Center in Rotterdam, revealed early findings from his latest study on “highly pathogenic avian influenza A/H5N1,” more commonly known as bird flu, avian flu or H5N1.
Avian flu, which lives in waterfowl, was first found in humans in 1997 when an outbreak in poultry in Hong Kong killed six people. The region’s entire chicken population was culled within three days, a mere trickle in the bloodshed that has since occurred as H5N1 has spread through birds across Asia, Europe and Africa.
The good news is this: H5N1 does not transmit well between humans; it isn’t “airborne.” People mostly catch it from infected chickens.
The bad news? During the last decade, there have been 615 recorded human cases, 364 of them fatal — a death rate of roughly 60 per cent. The great pandemic of 1918 had a death rate of approximately 2.5 per cent — and wiped out 50 million people.
Experts worry about H5N1 adapting to travel on the gusts of coughs and sneezes, making it far more contagious. If it does, the virus could lose its lethality and cause mild disease. On the other hand, the planet could look like the inside of a poultry house ravaged by H5N1.
“You walk into a chicken house and the chickens are all dead,” said Dr. Robert Webster, with the St. Jude Children’s Research Hospital in Memphis, who is widely regarded as the father of influenza virology. “That’s what’s at the very back of our minds.”
That’s why Fouchier’s announcement in Malta raised such a red flag. He had found a way to make H5N1 airborne.
Fouchier took an H5N1 virus and tweaked its genes to make it more receptive to mammals. He then “passaged” the virus back and forth between ferrets, an animal that mimics how flu viruses transmit in humans. After 10 rounds, the virus was airborne.
The journal Science was reviewing Fouchier’s study for publication. Concurrently, another scientist — Dr. Yoshihiro Kawaoka, a virologist with the University of Wisconsin-Madison — had submitted a paper to another journal, Nature, also involving an H5N1 strain that had been modified to become air transmissible.
Alarm bells rang. Could bioterrorists, or hostile states, use the studies to genetically alter the virus? What if a laboratory accident released the virus into the world, as happened at a Singapore lab with SARS in 2003?
The journal editors forwarded the manuscripts to the U.S. National Science Advisory Board for Biosecurity (NSABB). The independent board advises the government on “dual-use research” — research that could be used for malevolent purposes.
The board’s voting members were asked to decide: should these papers be published? Their answer was a unanimous no.
For years, they had tried to imagine what kind of research would be considered too risky to publish, said NSABB member Michael Imperiale, a virologist with the University of Michigan.
“We struggled — we struggled — to come up with anything,” Imperiale said. “So for this to (come along), it was like: wow.”
The NSABB’s next move was unprecedented: they asked the researchers to redact sections of the papers that explained how the viruses were created.
The request sparked an outcry. After all, the sharing of research is essential to scientific progress. But Fouchier and Kawaoka reluctantly agreed, on the condition that a system be established to share the information with approved scientists. By Fouchier’s estimate, some 1,000 experts qualified for that list.
In early January 2012, the New York Times ran an editorial under the headline “An Engineered Doomsday,” calling for Fouchier’s virus to be destroyed.
“We respect the researchers’ desire to protect public health,” it read. “But the consequences, should the virus escape, are too devastating to risk.”
The tone was at fever pitch. Fouchier and Kawaoka — along with dozens of leading flu researchers — did something anathema to scientists: they stopped their research. Kawaoka’s virus was also put into cold storage.
The moratorium was supposed to last 60 days, long enough to let researchers explain the benefits of their work and governments to consider their next steps. It dragged on for a year.
Last month, the moratorium was lifted.
The World Health Organization had issued safety recommendations and several countries had tightened rules around avian flu research. In Canada, the virus could only be studied in the most secure labs.
Fouchier and Kawaoka submitted revised papers that clarified an important point. When the mutated strains became airborne, they were less lethal; the ferrets infected by air did not die. Perhaps this was not the “doomsday virus” some had feared.
The NSABB realized the impracticality of sharing the redacted details with only a select group of people, and reversed its position last March.
The two controversial studies were published — in full.
But while the moratorium has ended, the discussion is hardly over, said Dr. Paul Keim, a microbiologist with Northern Arizona University and former NSABB chair. “It will be a long, slogging process where we start to develop rules about what should be done and what shouldn’t be done.”
Michael Imperiale wants more discussion on how science is shared. The tools for conducting sophisticated science have never been more accessible. DNA synthesizers can be purchased on eBay and Imperiale estimates his own university lab could recreate Fouchier’s H5N1 strain in one or two months.
“Here, in the 21st century, maybe we need to rethink how we communicate life-sciences research. I think the world has changed. There are more people out there who have no qualms about the way that they try to do harm.”
In the United States — the world’s biggest funder of avian flu research — the government is formalizing rules for approving research where pathogens are modified to become more dangerous.
But governments will have to strike a difficult balance. Too much oversight could hamper scientific progress; not enough could spell disaster.
The central question — do the risks outweigh the benefits? — can be endlessly debated. How does one predict the benefits of a specific line of scientific inquiry? Or the likelihood of a terrorist gaining the scientific skill, resources and resolve to unleash an H5N1 pandemic?
Flu researchers say they’re certain of one thing: who their adversary is.
“Nature is the greatest bioterrorist,” Webster said. “The greater risk is what Mother Nature is doing out there every day.”
Fouchier’s experiment discovered five to nine mutations that could put H5N1 in the air — all of which have been found in nature, albeit never all together in the same strain, according to Webster.
But fretting over nine mutations can also seem futile when one considers the countless ways a virus can evolve. “Learning about that one pathway produces no useful or actionable information,” said Richard Ebright, a chemistry and chemical biology professor with Rutgers University. “It makes no sense to invest scarce resources in research that does not have a path to clear application — and carries large risks.”
Ebright doubts Fouchier and Kawaoka’s findings can help vaccine or antiviral development, as they have asserted. The world still does not have an effective vaccine for seasonal flu, let alone one that would protect against a theoretical pandemic strain of H5N1, he said.
The flu researchers have also said that their findings could help disease surveillance efforts but others remain skeptical.
“It’s not clear to me that if they saw these mutations (in nature), they would be able to effectively stop them,” Keim said. “When the H1N1 (pandemic) emerged, by the time we knew it was a new virus emerging it was already in 18 countries.”
For Fouchier, such fears and reservations are not good reasons to stop fundamental research. To combat a potential H5N1 pandemic, the world must understand the virus.
“This is really what is so critical about our research; not the fact that we just made one virus that’s airborne. We now (have) much more insight into how flu viruses in general become airborne.”
Fouchier does not know what the payoffs of his research might be, or when they might be realized. But one revelation leads to the next, and this has always been the story of scientific progress. Breakthroughs are only the final link in a long chain of incremental discoveries — like, perhaps, the five to nine mutations that can make H5N1 airborne.
“It is not through fear that we will stop H5N1 from becoming pandemic,” argued Daniel Perez, an assistant virology professor with the University of Maryland, in an article for Science last year. “The pursuit of knowledge is what has made humans resilient — a species capable of overcoming our worst fears.”
Jennifer Yang’s last story for World Weekly was on the global hot spots for disease outbreaks.
The World Health Organization has been tracking human cases for avian influenza since 2003. Here are the latest numbers from the countries that have been hardest hit:
Indonesia
Cases to date: 192
Deaths: 160
Mortality rate: 83%
Egypt
Cases to date: 169
Deaths: 60
Mortality rate: 36%
Vietnam
Cases to date: 123
Deaths: 61
Mortality rate: 50%
China
Cases to date: 43
Deaths: 28
Mortality rate: 65%
Cambodia
Cases to date: 26
Deaths: 23
88%
Thailand
Cases to date: 25
Deaths: 17
68%
Turkey
Cases to date: 12
Deaths: 4
Mortality rate: 33%
Original Article
Source: thestar.com
Author: Jennifer Yang
No comments:
Post a Comment