H5N1 Flu Papers Published, but Moratorium Continues

The highly controversial report from Dutch flu researcher Dr. Ron Fouchier on creating a form of H5N1 avian influenza that’s airborne transmissible between mammals finally appeared this afternoon in Science magazine, after months of dickering over whether this paper would get published and what information it would include.

But, with much of the content of both Dr. Fouchier’s paper, as well as a report on a similar study by Dr. Yoshihiro Kawaoka that appeared last month in Nature, already fairly well known and widely discussed, perhaps the biggest news in today’s reports came in some of the related papers published by Science and in an update about the H5N1 research moratorium made during a press conference yesterday.

courtesy Plaskov, Wikimedia Commons

At the height of the mammalian-transmissible H5N1 debate last winter, Dr. Fouchier and Dr. Kawaoka and several other flu researchers declared a voluntary, temporary stop to any further research on the transmissibility or pathogenesis of H5N1. Speaking at a press conference on June 20 organized by Science magazine to discuss today’s package of H5N1 reports and analysis, Dr. Anthony Fauci, director of the National Institutes of Allergy and Infectious Diseases (which funded the transmissible H5N1 work), said, “The reason why you have not heard any announcement about the moratorium is that we are still struggling with the criteria for the next phases of experiments. We are working hard right now to get processes in place where we could have broad general criteria for the kinds of experiments that could be done.” A meeting is scheduled in July in New York that will bring together a worldwide group of influenza researchers and surveillance experts who will try to produce those criteria, Dr. Fauci said. The meeting “will discuss in detail the kinds of approaches we can have to try to expedite as quickly as possible the lifting of the moratorium.”

One of the new studies that accompany the Fouchier paper today is an analysis led by researchers at Cambridge University who used the findings on H5N1 mutations that contribute to mammalian transmissibility to develop a mathematical model to calculate the risk that such viruses could appear in nature. Their conclusion: Current best estimates indicate that the needed panel of mutations could evolve within a single mammalian host, making the possibility of a respiratory-drop transmissible strain of H5N1 virus occurring in nature “a potentially serious threat.” But a more quantifiable estimate of the risk—a specific number—is not yet possible, they said.

“We now know that we are living on a fault line, an active fault line,” when it comes to the potential for H5N1 to become mammalian transmissible in the real world, said Dr. Derek J. Smith, head of the Cambridge group, during yesterday’s press conference. “Now what we need to know is how likely it is.”

Another part of today’s H5N1 package dealt with steps that could be taken right now to speed up influenza vaccine production in response to a newly emerged pandemic strain, something that warrants its own blog post.

—Mitchel Zoler (on Twitter @mitchelzoler)

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Filed under Health Policy, IMNG, Infectious Diseases, Internal Medicine

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