Friday, December 23, 2011

Security in Flu Study Was Paramount, Scientist Says

The National Science Advisory Board for Biosecurity, concerned about bioterrorism and a worldwide pandemic, has for the first time ever urged scientific journals to keep details out of reports that they intend to publish on a highly transmissible form of the bird flu called A(H5N1), which has a high death rate in people. Working with ferrets, researchers on the virus at two medical centers — Erasmus Medical Center in Rotterdam, in the Netherlands, and the University of Wisconsin-Madison — are investigating genetic changes that may make the virus more easily transmittable to people. Doreen Carvajal spoke with Ron A. M. Fouchier, the lead researcher at the Erasmus Center. An edited and condensed version of the conversation follows.

Q. What was your reaction to efforts to censor the research?

A. The draft recommendations reached us at the end of November, and since that time we have been working with the journals and the international organizations to figure out a way to deal with it, because this is an unprecedented issue in science.

In principle, we of course understand the statement by the National Science Advisory Board for Biosecurity and the United States government. This is dual-use research, meaning research that can be used for good and bad purposes.

The N.S.A.B.B. advice is that we can share this in a restricted form.

We would be perfectly happy if this could be executed, but we have some doubts. We have made a list of experts that we could share this with, and that list adds up to well over 100 organizations around the globe, and probably 1,000 experts. As soon as you share information with more than 10 people, the information will be on the street. And so we have serious doubts whether this advice can be followed, strictly speaking.

Q. So what is the solution?

A. This is very important research. It raises a number of important issues that need to be shared with the scientific community. And because we cannot keep this confidential with such a large group. I think the only solution is to publish in detail.

Q. How do you sum up the most vital information that should be shared?

A. There are three aspects that need to be shared.

The first part of the work can be shared without detail. The message is that H5N1 can go airborne between mammals. Of course, we have also showed how this virus can go airborne, and which mutations cause this virus to go airborne. And those mutations, the info of those mutations, need to come in the hands of people who are doing research — for instance, the people who are doing surveillance in countries affected by H5N1. If those mutations would be detected in the field, then those countries affected should act very aggressively to stamp out the outbreaks, to protect the world.

So if we can stamp this virus out before it actually emerges, then we prevent a pandemic. And I think that is what we all want.

But even if we would not be able to prevent a pandemic — and let’s assume that there is a very small chance that the virus will emerge in nature — then our last resource would be drugs and vaccines.

Now, drugs and vaccines are normally evaluated with bird flu viruses that are not adapted to mammals. Now the questions are whether those vaccines are effective against the mammal-adapted virus. And so by doing this research, we are able to get ahead of this virus emerging in the field to test whether our last resource would be functional.

So the three things are: one is the simple fact that it can go airborne. That means that all the advice from the scientific community to outbreak countries now can be more unanimous that H5N1 is a very big risk to human health. The second thing is surveillance, and the third thing is preparation by evaluating vaccines and antivirals.

Q. What were the precautions that you took, if any, in the course of your research to guard against terrorism?

A. This experiment was not designed overnight. We started planning for these experiments 10 years ago, consulting with experts nationally and internationally about how to do this safely. We built special facilities to protect people against the virus and the virus against the people.

Q. What was special about your facilities, in the Netherlands?

A. The biosafety information can be found on our Web site. The biosecurity, I cannot release any information.

Q. Over that period, were there any safety issues?

A. Everything was smooth. There were layers upon layers upon layers of biosecurity measures. The design of this type of facility was such that it would be very unlikely for all barriers to break at the same time.

Q. How did you conduct the research?

A. I cannot disclose the methods, because the methods are supposed to be a recipe for bioterrorism.

We mutated the virus and then performed a natural selection for additional mutations. We were testing on ferrets. We designed the experiment over the course of 10 years. We have been doing hands-on work on the experiments for the last two years, testing on dozens of ferrets.

Q. Is the research finished?

A. We are continuing the work. We need to evaluate vaccines, and we need to evaluate antiviral drugs and how well they work against this virus. We also need to have a more general understanding of whether this virus could acquire abilities of airborne transmission in other ways.

Q. Have you seen any sign that government authorities or anyone else was monitoring you because of concerns about terrorism?

A. I am sure I am being monitored by many governments. But also the usual states, not only the rogue countries. If they are monitoring me, they are doing a good job of staying out of my sight.

Q. How easy is it to recreate this virus?

A. It is not very easy. You need a very sophisticated specialist team and sophisticated facilities to do this. And in our opinion, nature is the biggest bioterrorist. There are many pathogens in nature that you could get your hands on very easily, and if you released those in the human population, we would be in trouble.

And therefore we think that if bioterror or biowarfare would be a problem, there are so many easy ways of doing it that nobody would take this H5N1 virus and do this very difficult thing to achieve it.

You could not do this work in your garage if you are a terrorist organization. But what you can do is get viruses out of the wild and grow them in your garage. There are terrorist opportunities that are much, much easier than to genetically modify H5N1 bird flu virus that are probably much more effective.

Q. How difficult would it be to recreate it?

A. If we get this in the hands of labs that can already do it — such as the C.D.C. or N.I.H. laboratories — they would be able to repeat our work in a matter of weeks. But for rogue countries or terrorist groups, this would take years of work.

Q. So why such concern — aren’t you offering information that will protect countries?

A. That’s a question you should address to the advisory board. That’s our opinion, and we think this work should have been published in detail.

Q. What is your next step?

A. We will respect this advice, because this is the consensus for now. And we will work toward publishing a manuscript without the details, and we will wait on how the N.S.A.B.B. and the United States government envisages sharing the information in a classified way. As I said, we have doubts this is possible.

Q. Did you consider publishing anyway?

A. Yes, we could even launch it on our own Web site. We could do that. Of course, that’s not the smart way to move. There is an intense debate in our field, and it would be silly for us to act on our own on this. It’s better to have this discussion in the scientific and health community and see where it goes. If everybody agrees that this is the way to go, then we will respect that.

Q. What was the reaction from colleagues?

A. The only people who want to hold back are the biosecurity experts. They show zero tolerance to risk. The public health specialists do not have this zero tolerance. I have not spoken to a single public health specialist who was against publication. So we are going to see an interesting debate over the next few weeks between biosecurity experts and public health experts who think this information should be in the public domain.

NYT

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