The A(H5N1) Conundrum
Are there some experiments that should never be carried out? Is there some knowledge that is too dangerous for humans to possess? Can the dissemination of knowledge, once it has been discovered, be limited to only a few people?
These are some of the questions being raised by two papers from two virology groups that created an avian H5N1[A(H5N1)] influenza virus that is easily transmissible from mammal to mammal through the air. A federal advisory board has taken the unprecedented step of asking the journals Science and Nature not to publish details of the work to prevent them from becoming known to would-be bioterrorists (C&EN Latest News, Dec. 21, 2011).
A(H5N1) doesn’t usually infect humans. Of the 600 or so humans who have contracted the virus in the past decade, apparently directly from infected birds, about 60% died, a rate frighteningly higher than the estimated 2% who died after contracting the Spanish flu in the devastating 1918 epidemic that killed 20 million people worldwide. The saving grace of A(H5N1), so far, is that it does not pass from human to human through the air.
The work under review, done at the University of Wisconsin, Madison, by Yoshihiro Kawaoka and coworkers and at the Erasmus Medical Center in Rotterdam, the Netherlands, by Ron Fouchier and coworkers, was designed to find out whether A(H5N1) could evolve the ability to spread between mammals through the air. Fouchier presented some details of the work at a conference in Europe in September 2011. From sketchy press reports it appears that infecting one ferret—the mammal model of choice for studying flu virus transmissibility among humans—with A(H5N1) and then taking virus from the infected ferret and infecting another eventually led to an A(H5N1) that could be transmitted from one ferret to another in an adjacent cage through the air. It’s been reported that a total of five mutations in the viral genome led to the air-transmissible A(H5N1).
Some experts have now been quoted in press reports arguing that the research should never have been carried out in the first place, that creation of the transmissible A(H5N1) was irresponsible. That’s an untenable position. If there are a set of mutations that will make A(H5N1) transmissible among humans, then that set of mutations will one day occur in the wild. Better to know what those mutations are and be on the lookout for them in wild strains than to become aware of them once a pandemic has broken out. And if this is a virus we will someday face, it would be a good idea to begin to study its weaknesses.
More complicated is the question of who should have access to the details of the work. After the National Science Advisory Board for Biosecurity (NSABB) requested that details regarding the scientific methodology and specific viral mutations be deleted from the papers before they were published, Bruce Alberts, editor-in-chief of Science, put out a statement that said, in part, that the transmissible A(H5N1) “is sensitive to antivirals and to certain vaccine candidates and knowledge about it could well be essential for speeding the developments of new treatments to combat this lethal form of influenza.” He continued that, while supporting the work of NSABB, “Science has concerns about withholding potentially important public-health information from responsible influenza researchers” and that the journal’s final decision would be heavily dependent on the U.S. government setting out a plan for making the information available to such scientists.
How one goes about that isn’t at all clear. And if 100 or 1,000 researchers are given access to the information, will it really be any more secure than if it were simply published?
The idea of a terrorist trying to turn A(H5N1) into a weapon is scary. What’s more scary is the certainty that someday, somewhere, an air transmissible A(H5N1) is going to emerge in the wild. When it does, we’d better be ready. Being ready means as many researchers as possible should be working on the problem. That argues for rapid publication of the complete research.