Continuing influenza research necessary for pandemic prevention and control, say PIs
The threat of influenza pandemics is a continual worry for public health officials and the bird viruses that acquire the changes enabling them to easily infect humans are a known cause of these pandemics. Thus, preparedness measures aimed at mitigating the impact of bird flu pandemics are in place worldwide and have recently been updated by the World Health Organization (WHO).
However, how influenza viruses become contagious to mammals is largely unknown. As a consequence, the pandemic risk of the many kinds of different circulating influenza viruses can’t be assessed with certainty and the most effective counter measure deployed. Thus, in a comment article in Nature, Kawaoka argues researchers “should pursue transmission studies of highly pathogenic avian influenza viruses with urgency.”
Some people hold that the risks of studies on pandemic H5N1 outweigh the benefits, Kawaoka says, and counters this belief by noting that influenza viruses mutate constantly and those circulating in nature already pose a threat. Thus, it would be irresponsible not to study the underlying mechanisms that confer contagion in mammals, he adds. Such information is not only necessary for the development of effective vaccines and drugs, it also enables surveillance teams to monitor outbreaks for the most dangerous mutations and react swiftly thereby stopping a full blown pandemic before it starts.
Why should the NSABB tell the world what to do?
“Why has not the world already had these discussions and debates?” asks Paul S. Keim Ph.D., Professor of Microbiology at Northern Arizona University and Acting Chair of the NSABB.
When the NSABB was asked to review two papers showing that the highly pathogenic avian virus influenza A/H5N1 virus could adapt to mammalian hosts and be transmitted via respiratory droplets from animal-to-animal, it was decided that the work had great potential for harm or misuse and “recommended that the general conclusions highlighting the novel outcome be published, but that the manuscripts not include the methods used and other details that could enable replication of the experiments by those who would seek to do harm,” says Keim who explains, in a recent commentary in mBio, that “The recommendation not to publish scientific results was highly unusual and the first such recommendation by the NSABB,” a group dominated by actively practicing basic research scientists who have consistently advocated for open publication practices.
However, Keim stresses that although “the H5N1 virus rarely infects humans, when it does it causes catastrophic disease,” and points to the documented devastation of the 1918 influenza pandemic, a “testament to the powerful potential of influenza.” A pandemic by the more virulent H5N1 virus could cause such devastation “that it should be prevented at all costs.” He points out to this reporter that “The global impact of 60% mortality in a pandemic flu surpasses the imagination,” and asks if anyone thinks that policy in this area should be determined by individual research scientists.
That the deadly bird flu virus can adapt to mammal-to-mammal respiratory transmission is the most important conclusion of this research; one that policy makers, granting agencies, public health officials and vaccine and drug developers can use to improve the influenza-fighting infrastructure, according to Keim. “The details of the research, on the other hand, would add little to this short-term effort and could enable someone to replicate the work in a short period of time, perhaps by a person with nefarious intent.”
The bigger issue is deciding how future research will be carried out and sensitive material disseminated, says Keim noting that the need for global debate to develop policy has always been in the NSABB discussions. “What is gratifying and essential is that the debate is occurring; it is occurring on the international stage, and it is occurring rapidly,” he adds. Moreover, the influenza research community has agreed to a voluntary short-term moratorium on high-risk research, the WHO is facilitating global policy and the U.S. Government is working on guidelines for the distribution of restricted information. Thus, Keim considers the NSABB recommendations effective in both their primary and secondary goals.
Fouchier, R.A.M., Garcia-Sastre, A., Kawaoka, Y., et al. Pause on Avian Flu transmission Research. Science Express: Published online January 20, 2012; 10.1126/science. 1219412. Accessed January 3o, 2012.
Kawaoka, Y. Flu transmission work is urgent. Nature. (2012). doi: 10.1038/nature10884. Accessed January 30, 2012.
Personal communication: Yoshihiro Kawaoka DVM, Ph.D and Paul S. Keim Ph.D.
Note: The American Society for Microbiology’s 10th Biodefense and Emerging Diseases Research Meeting, being held on 26-29 February 2012 in Washington D.C., has added a session on the NSABB’s recommendations for H5N1 research. More information about the meeting in general can be found here.
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