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FAQ H5N1 Bird flu virus

Influenza virus experts, including Erasmus MC virologists, will be resuming their research on the transmission of the H5N1 avian influenza virus. The research had initially been put on hold for a period of 60 days but this period has now come to an end after a year. Below are answers to most frequently asked questions on the research and on the moratorium.

What was the research with H5N1 about?

In 2011, virologists from Erasmus MC and the University of Wisconsin made an important discovery. They discovered that the H5N1 avian flu virus can mutate to become airborne in mammals, and thus also possibly between humans. As few as five mutations could be enough to make the H5N1 virus transmissible in the air. The researchers discovered new mutations associated with the spread of the virus.

Why was the research actually carried out?

The virologists wished to determine if and how avian flu viruses become airborne in mammals. Little is currently known about how these viruses adapt to mammals and become transmissible between humans via coughing, sneezing, breathing, speaking, or indirect contact. The researchers used the H5N1 virus for their research because it was assumed that this avian flu virus could not become airborne in mammals, and would thus not pose a serious threat to public health. By using this virus in particular, the researchers could kill two birds with one stone. In addition to gaining a better understanding of the transmissibility of viruses it would increase the ability to assess if and when the risk of an avian flu pandemic increases.

Why is the study important for public health?

By showing that the H5N1 virus can become airborne in mammals, authorities can be strongly urged to contain outbreaks among poultry with a great sense of urgency. The research data can be used in surveillance programs to identify outbreaks in which the likelihood of the development of transmissible viruses is greatest, and take extra measures. The main benefit for public health is that the emergence of a pandemic can be prevented in this way.  In addition, it enables the researchers to better assess the effectiveness of existing vaccines and drugs for the transmissible avian flu virus as they now have a virus available for testing.

There was much controversy about the research, was this justified?

In some countries, such as the United States, there was much commotion when it was announced that researchers had created a virus that is transmissible among mammals. Initially, bodies such as the American National Science Advisory Board for Biosecurity (NSABB) did not want the researchers to publish their findings in a scientific journal. They feared that villains would be receiving a recipe to reproduce the virus.
Virologists at Erasmus MC and many other experts considered the controversy unjustified. The researchers had made no changes to the virus in their laboratories that could not also have freely occurred in nature. Furthermore, the virus does not appear to spread as easily through the air and was not lethal. It would not be of much use to malicious individuals.

The researchers were adamant about publishing the results, why?

Publication in a scientific journal meant that the data could be quickly shared with other experts making further research and good surveillance programs possible. Fortunately, the opponents of publication eventually saw that the virus was not as dangerous as originally thought and agreed that the benefits of publication outweighed any disadvantages. This meant that the research could as yet be published in full in Science in June 2012.

Why was a moratorium imposed on the research?

Halfway through the period of controversy, at the end of January last year, the researchers voluntarily decided on a self-imposed 60-day moratorium. This meant that they would not carry out any research in this period on the viruses they had created. The pause period was imposed to give national and international governments the time to determine whether existing rules and regulations and the enforcement thereof are sufficient to safeguard the safety of people and the environment.

We are now a year on, why was the moratorium so long?

In February 2012, the World Health Organization (WHO) asked the researchers to continue the moratorium on their research. The WHO recommended that research not be resumed until the benefits of the study for public health were clearly communicated to the outside world and the relevant authorities were convinced that further research could be carried out under safe conditions.

Have these requirements been met?

Yes. Once the research was published, the researchers shared and discussed all the details of their research with the outside world. Explanations were given to citizens as well as experts through the media, conferences and meetings, etc. The authorities of the countries in which research is being carried out on the transmission of the H5N1 avian flu virus have sought advice in the field of biosafety, so that the research can be conducted safely. Researchers in the United States will have to wait slightly longer until the formal decision relating to the recommendations has been taken before being allowed to resume the research.

Why is further research on H5N1 needed?

A better understanding of how avian flu viruses adapt to mammals and become airborne can possibly help prevent pandemics in the future. The researcher’s studies have already partly unraveled this secret, but further research will need to be carried out. They wish to carry out further research on the biological traits associated with each of the mutations identified. It is as yet unclear what the recently identified mutations contribute. In addition, the researchers want to determine whether the mutations identified also make other flu or avian flu viruses airborne. Furthermore, they want to know how easily these mutations occur in nature. To this end, additional surveillance studies are needed in mammals, including humans. And finally, the researchers want to study the effectiveness of vaccines and drugs, should a pandemic become unpreventable in the future.