After scientists have engineered a new strain of H5N1, commonly known as bird flu, which is readily transmitted between humans, the Annals of Internal Medicine , the principal journal of the American College of Physicians, has published two perspectives online in advance, in which concerns are raised as to whether or not this research should be continued, and how the data should be shared for the benefit of public health.
The H5N1 virus that is circulating at present has an extremely high mortality rate, killing approximately 60% of the more than 500 confirmed human incidents, but in comparison to seasonal flu, this strain has not has not spread easily amongst humans. Two research teams, who bear no relationship with the perspective of Annals authors, have recently engineered the H5N1 virus to make it readily transmissible between ferrets, meaning that it may also be able to make it easily transmissible between humans. Their research has raised controversy in terms of safety factors and appropriateness.
A recommendation to publish the H5N1 research by The National Science Advisory Board for Biosecurity (NSABB) has evoked strong reactions amongst the scientific community. Particularly, the recommendation for journals to publish the work without detailed methodology, to eliminate the risk of replication and purposeful misuse. This has caused a division amongst the scientific community into those who are for censorship, and those who oppose it.
The first Annals perspective writes about Thomas V. Inglesby, MD, CEO and Director of the Center for Biosecurity of University of Pittsburgh Medical Center perspective, who states that the possible consequences of an engineered human transmissible H5N1 strain are devastating. Should the newly engineered strain escape the laboratory, regardless of whether by accident or on purpose, and spread as widely as seasonal flu, hundreds of millions of people's lives could be endangered due to the highly contagious and deadly nature of the mutant strain, which could result in catastrophe. Even though the research was conducted to gain more scientific knowledge of H5N1, there is no scientific evidence that a strain like the one developed in the laboratory will ever occur naturally.
Dr. Inglesby therefore concludes that the dangers of the research outweigh the benefits, declaring:
"If we are asking society to take the substantial and unprecedented risks associated with a human-transmissible H5N1 strain with a nearly 60 percent case-fatality rate, we had better have a compelling, concrete, and realistic public health justification for it."
He recommends that if the experimentation must continue, it should be under very restricted use, similar to the approach taken with smallpox.
The second Annals perspective was written by Andrew T. Pavia, MD, Chief of the Division of Pediatric Infectious Diseases at the University of Utah Health Sciences Center and Primary Children's Hospital, who claims that the H5N1 virus may not be as easy to transmit between humans as some scientists believe. He believes that it would be unlikely that H5N1 would be used as a bioweapon, given that in order to manipulate H5N1 as a weapon, terrorists would require significant scientific skills as well as knowledge of precise methods used in the studies.
According to Dr. Pavia, these and future studies should proceed with appropriate safety aspects, as it increases vital scientific understanding of influenza.
At present, there is no transparent and considerate system to ensure that only those with a legitimate need for the data are provided with access and to decide who these people are. In general, Dr. Pavia supports the approach taken by the NSABB and claims that there is a purpose for creating more dangerous pathogens in a laboratory, saying:
"We must have a careful and balanced approach that is neither too timid in permitting the performance and sharing of critical research nor too naive in confronting the biosecurity issues posed by that research."
In the meantime, the researchers have announced a self-imposed, 60-day suspension on their research whilst the debate continues.
Written by Petra Rattue