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"When you get something out in the general literature, you stimulate thought and input from people who at first glance you wouldn't think would have an interest in it," he added. He said publication can trigger involvement by people in a wide range of disciplines, which can pay benefits.
Some biosecurity experts, though, voiced misgivings today.
Eric S. Toner, MD, senior associate in the Center for Biosecurity at the University of Pittsburgh Medical Center, commented by e-mail, "I think that the publication does increase the probability that others will want to replicate the experiments and pursue this line of research further. The more labs that are doing this research, the more likely an accidental escape becomes.
"Clearly if all the lab workers were effectively vaccinated against the virus, the risk of accidental escape would decrease. The paper says the lab workers were offered H5N1 vaccination. It would be nice to know if it was required and that the workers had good antibody titers as well as that the specific H5N1 vaccine had demonstrated efficacy against the research strain."
Toner also said the findings strongly support the concern that a naturally occurring H5N1 pandemic is possible. But he called the findings "only modestly useful" for flu surveillance.
"Many of the mutations they reported were previously known to be ones of concern," he said. "For the other mutations that had not previously been suspected to be associated with mammalian transmission, the paper suggest that it may not be individual mutations that are important but rather various combinations of mutations that produce a similar result. Knowing the significance of all the possible combinations of a nearly infinite number of possible mutations is beyond our current capabilities."
He added that the study underlines "the pressing need for a much more robust global surveillance effort, including much more sequencing and much more timely reporting of sequencing data. It also underscores the need to have a global action plan based on the surveillance. In other words, what do we do that we are not doing now if we find increasing evidence of worrisome mutations?"
An NSABB member who opposed publishing the full version of Fouchier's paper maintained that position today and expressed concern about the bosafety risks if other labs around the world use the findings to launch similar studies.
Michael T. Osterholm, PhD, MPH, director of the University of Minnesota's Center for Infectious Disease Research and Policy, publisher of CIDRAP News, said he supports the type of research done by Fouchier and Kawaoka and thinks it should continue, but not in labs all over the world.
He said the Fouchier and Kawaoka studies mark the first time humans have ever broken the barrier between nontransmissibility and transmissibility of a pathogen in animals. The heart of the issue is transmissibility, not the virulence of the lab-derived viruses, he asserted.
What a ferret-transmissible H5N1 virus would do in humans is unknown, he commented. "But if it started to circulate, such as in swine, all bets are off. Once you break that transmissibility barrier, this virus is open for serious mischief."
The details of Fouchier's study "should've been disseminated on a need-to-know basis," Osterholm said. "I think we punted on this, we didn't exhaust every possibility for disseminating it." He was referring to the conclusion of most officials and scientists involved that it was not possible to quickly devise a way to share the details only with a select group.
"We're making it much easier for everyone to do this," he said. "What if some vaccine manufacturing company in a developing country decides they want to work with this and it gets out?"
He commented that the release of a dangerous flu virus through a lab accident has already happened once, with the re-emergence of the H1N1 virus in 1977: "That was a clear case of a virus that leaked out of work that the Russians were doing."
Osterholm also warned that the issues raised by the Fouchier paper won't go away, saying research papers now in the pipeline will raise even greater concerns about possible misuse and biosafety.
"I think the federal government and the NSABB are very poorly position to deal with the future manuscripts that are already in the pipeline," he said.
Another NSABB member, David A. Relman, MD, of Stanford University, expressed the view that the Fouchier study shouldn't have been done in the first place, let alone published.
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