There are other important things going on in the world, but the H5N1 issue continues to simmer in the background. Speaking of background, here are some Daily Kos stories laying out the tale, including from March 2006: H5N1: Liberate The Sequences! Free The Researchers!
From Nicholas Zamiska, WSJ:
Scientists around the world, racing to discover how avian influenza is spreading and whether it is evolving toward a pandemic strain, face a dilemma: Should they share their interim findings widely, show them only to a select set of peers, or keep them to themselves until they can publish papers, often critical to their careers?
The guilty parties here are WHO and our own CDC (but not NIH or NAMRU, an infectious disease surveillance branch of the US Navy). In fact, US House members led by
Dennis Kucinich (Democrat, Ohio) and Wayne Gilchrest (Republican, Maryland are circulating a letter in the House of Representatives that calls on Michael Levitt, the US health secretary, to require H5N1 sequences and other publicly funded research data "to be promptly deposited in a publicly accessible database, such as GenBank".
The letter has now been sent, signed by 16 members of Congress: you can read it here.
and either thank them or encourage them here. But the heat's being turned up. The prestigious journal Nature continues to lead the way (here's a summary and commentary from Effect Measure for those without a subscription.
Virus isolates from six of the eight family members have been sequenced, but the WHO has not released the data, saying that they belong to Indonesia. Instead, the agency released a statement on 23 May stating that there was "no evidence of genetic reassortment with human or pig influenza viruses and no evidence of significant mutations".
Nature has now obtained more detail on the genetic changes, which suggest that although the WHO statement was not incorrect, plenty more could have been said. Viruses from five of the cases had between one and four mutations each compared with the sequence shared by most of the strains. In the case of the father who is thought to have caught the virus from his son -- a second-generation spread -- there were twenty-one mutations across seven of the eight flu genes. This suggests that the virus was evolving rapidly as it spread from person to person.
Did you know TIME has a health blog? Yesterday, they covered the story in a post called Secret Sequences:
When H5N1 avian influenza hit a family in rural Indonesia in May, killing seven of eight people infected, it marked the most serious known incidence of human-to-human transmission of the virus.
More about this on the flip.
The most immediate response involved examining and tracking anyone who had come into contact with the infected, to make sure that the virus hadn't spread beyond the family, which could have marked the beginning of a pandemic. But scientists were also quick to obtain virus samples taken from the outbreak and genetically sequence the isolates back in labs in Hong Kong and Atlanta. By comparing the genetic code of viruses taken from the new outbreak to past strains of H5N1, scientists could hope to see if the bird flu virus had mutated in such a way that could make it more likely to pass from person to person.
At the time the WHO issued reassuring statements that there had been "no significant mutations," but an article in this week's Nature (subscription required) argues that the UN health agency may have been underplaying the situation. Nature obtained greater detail on the genetic sequences of the Sumatra viruses and found that they had accumulated a number of mutations--which suggests that the virus was evolving rapidly as it spread from person to person.
Here are a few things to keep in mind:
Again, from TIME:
It should be a no-brainer--the more scientists allowed to look at the H5N1 sequences, the thinking goes, the more likely someone will generate a fresh insight. But as is often the case with bird flu, politics are at least as important as public health. The WHO says that the sequences are the property of the member states that supply them--in this case Indonesia--and if those countries want the data kept confidential, there's nothing the UN body can do.
Because international cooperation is critical in the fight against bird flu, WHO officials are loathe to press member states to allow the sequences to be released. (China, for instance, keeps almost all of its H5N1 isolates to itself.) Poor countries like Indonesia are also worried that if a vaccine or drug is developed elsewhere from one of "their" viruses, they'll be cut out of the scientific glory and the profits. And some of the scientists who are allowed to see the sequences might not want the data to become public before they can publish their work.
Still, with all the emphasis that's been placed on the importance of openness when it comes to fighting avian flu, it seems a tad hypocritical for such vital data to be kept confidential. As soon as possible, the sequences should made public.
The fact is that another flu pandemic with some emergent virus is inevitable some day (we average three per century), an H5N1 flu pandemic remains possible (and that would be astoundingly bad news), we are not doing a stellar job in preparing, and while politicians and administrators dither, new cases of H5N1 in humans will continue to occur, especially in the fall when the viral season heats up again (and every human case is another chance for the virus to mutate to a form more easily transmissible to humans).
Since you can't lobby a virus, there are those who are lobbying Congress and WHO to free the sequences and help the world by ending the practice of sequence witholding. This is Open Source politics and Open Source science at its best (full disclosure: I have no financial or scientific stake in this other than a major interest in avoiding or mitigating a pandemic).
Crossposted at Daily Kos.