Bad Bioethics Headline: 1918-like flu edition

Terrence McCoy has an article in the Washington Post‘s “Morning Mix” on the 1918-like flu virus gain-of-function study. It provides a bit of extra information beyond the coverage at the Guardian, and is worth a read.

The article, unfortunately, has a terrible headline. A “we need an award for Bad Bioethics Headlines” headline.

The headline reads “Was it ‘crazy’ for this scientist to re-create a bird flu virus that killed 50 million people?” There are some glaring errors, or misinformation, embedded in this headline; errors that, unfortunately, aren’t explicitly dealt with in the content of the article. And the errors, to a certain extent, undercut the seriousness of the work done.

1) First, nothing was “re-created.” The 1918 strain of H1N1 influenza has already been recreated using reverse genetics—in 2005. This work is also widely considered dual-use research of concern.

The work performed by Kawaoka and his team, however, is not a recreation in the traditional sense—the sense we mean when we talk about piecing together a poliovirus, or synthesizing Spanish flu. Rather, this new research involved piecing together a “1918-like” virus—one whose proteins differ by a few amino acids from the one that emerged almost a century ago—using segments of avian influenza. This wasn’t a recreation; it was just creation pure and simple.

2) The influenza pandemic in 1918 isn’t really “bird flu” in the conventional sense. Sure, it is likely that the strain of flu in 1918 emerged from an avian (and swine) reservoir at some point, but that’s because of the 18 different types of hemagglutinin (the “H” in H1N1), and 11 types of neuraminidase (the “N” in H1N1) that we know of, all of them can survive in birds. So all flu has something to do with birds.

We tend to label viruses as "bird" or "pig" viruses when we're talking about the most common host.

We tend to label viruses as “bird” or “pig” viruses when we’re talking about the most common host.

But that’s definitely not what we typically mean when we talk about “bird flu.” Avian influenza is used to describe influenza viruses that arise predominantly or exclusively in birds. What makes H5N1, or H7N9 scary is that they are viruses that predominantly occur in birds, that are crossing over to humans. Fortunately, H5N1 hasn’t been terribly successful at this, and H7N9—while more successful—is not at pandemic levels. Yet.

The “recreated” virus isn’t an avian influenza virus in the same way. The influenza that served as its template is ostensibly “human” or at least “mammalian” flu, that to the best of our knowledge came about from both avian and swine viruses that combined to make a human-transmissible superbug. The parts from which this novel strain was stitched together are bits of bird flu.

The point Kawaoka has been trying to sell the world on is that he wanted to find out—for the good of us all, he has claimed—if something like 1918-influenza could emerge from H5N1. Apparently, the answer is yes.

These all matter because they bear heavily on the “why?!” of this story. This virus didn’t come out of nature, but rather was made in a lab. And it hasn’t been recreated, but outright engineered. As with other gain of function studies, proponents of this story like to say that this will raise awareness about the pandemic preparedness, disease surveillance, and so on. I’ve voiced my skepticism about this before.

It also matters because—as the study notes—the virus created isn’t as harmful as 1918 influenza, but more harmful. Kawaoka’s paper notes that the virus his team created is more pathogenic than an authentic avian influenza virus, or the 1918 influenza pandemic strain. We’re not dealing with Spanish influenza: this is a human created, mammalian transmissible strain of flu that outperforms the “Mother of All Pandemics” in trials. That’s scary. And, while they were only testing the strains on three ferrets at a time, which isn’t enough to give us an idea of how this would affect humans in an outbreak, it is certainly enough to give us pause.

There is power in the platform. The Washington post, by its own numbers, has a readership of 24 million people. It should probably work a little on its headlines.




One thought on “Bad Bioethics Headline: 1918-like flu edition

  1. Pingback: What am I reading? 15 June 2014 | The Broken Spoke

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