Reading Room Production — page 379

Our NIH-supported center of excellence is supporting surveillance for H5N1 virus in domestic animals in one of the H5N1 endemic countries; our surveillance researchers have told us that the finding of an H5N1 virus with specific mutational changes in poultry would not result in widespread culling activities unless the birds are sick. Immediate culling is supposed to be the standard protocol now for the control of H5N1 virus, but resources for a number of the H5N1 endemic countries are often lacking to detect the virus or support programs. The voice of these and similar on-the-ground experts was missing from our discussion regarding the benefit of making these mutation data general available. Setting aside the fact that surveillance experts noted above were not invited as subject matter experts, it is notable that current news sections in both Science and Nature have published a series of articles on the controversy of using the H5N1 virus mutation information for surveillance and control purposes. Several of these stories were well researched, with numerous interviews with some of the experts I noted above. Their conclusions were consistent with my comments above regarding the utility of making the mutation data from these studies generally available and the impact on the control of H5N1 infection in poultry. None of these news stories were referenced in the meeting (except by me) or provided as important background information leading to a more complete risk-benefit analysis. There was no discussion as to the limited number (and time from sampling to testing) of H5N1 viruses sequenced from endemic countries or how to improve that situation in the endemic countries before the release of the mutation data could yield even remote benefit. The most important aspect of the results in these two studies on surveillance and control has already been accomplished; namely alerting the world to the possibility that H5N1 influenza virus surely can become a mammalian-transmitted virus and poses real pandemic potential. We must be much better prepared to respond to a possible H5N1 influenza pandemic than we are today. Publication of the full study methods and result of either manuscript will not enhance this conclusion. Finally, I believe it was unfortunate that Dr. Smith was able to present the work on the population-based mutational changes in H5N1 viruses without an opportunity for others in the influenza field to provide commentary. Since Dr. Fouchier was a coauthor of the work, it hardly represented an unbiased view of H5N1 virus genetics. Was the manuscript that Dr. Smith presented peer-reviewed? While I appreciate that he is a leading influenza researcher, for the sake of balance others without a primary interest in these manuscripts should have led this discussion. Security considerations and the risk of malevolent applications of the mutation data. One of the most disturbing aspects of the meeting was the security briefing on the evening of March 29th. It was one of them most incomplete and, dare I say, useless classified security briefings I've ever attended. For the past 20 years, I have held security clearances in my work with international and national bioterrorism, including a top secret clearance in my role as a special assistant to HHS Secretary Tommy Thompson from 2001 to 2004. I have served as a briefer for some of our leading government officials during that time. I do understand threat assessment and the limitations and strengths of intelligence.