Scientists are embarking on a series of experiments with the bird flu virus
ravaging Asian poultry to see how dangerous it would be if it adapted to humans,
the chief influenza expert at the U.N. health agency said Tuesday.
Researchers will mix the virus with a human flu variety to see how well they
swap genes and test various combinations on ferrets and other animals to
determine which would be the most hazardous, said Klaus Stohr, chief flu expert
at the World Health Organization, which is coordinating the tests.
What we want to do is
reduce surprises. Every surprise will cost lives," Stohr said in Geneva. "We still
have the time here to do the research. We don't have much time, but the pandemic
isn't there yet."
The avian influenza outbreak has forced the slaughter of more than 80 million
chickens and other fowl in Asia, but human infections remain rare.
Experts agree it is only a matter of time before a deadly human flu pandemic
develops, and most suspect the current bird flu strain is the most likely
candidate to cause it.
"It's not a virus which we have been able to get rid of. It comes back, comes
back and these outbreaks are getting bigger and bigger," Stohr said. "This is
the virus which everyone would bet their money on."
There are two ways the bird flu virus sweeping Asia could become a serious
danger to humans.
In one, it could accumulate enough genetic mutations on its own to become
good at passing between humans. Experts are tracking the virus to detect any
significant genetic changes, but so far none has been recorded.
The more scary possibility would be a sudden change in the virus, brought on
by combining with a human flu strain in someone's body. The two viruses could
swap genes and create a potent hybrid with the deadliness of the bird strain and
the contagiousness of a regular human strain. It only takes one person with a
double infection to set off such a chain of events, Stohr said.
Studies in monkeys using only pure bird flu virus
will be conducted in Rotterdam, the Netherlands, at the same
laboratory where key experiments involving the SARS virus were carried out, Stohr said.
Results are expected by the end of March. The locations for laboratory studies
and experiments on other animals have not yet been announced.
Studying how the pure bird flu virus behaves in monkeys is considered a good
indicator of how a pandemic strain based on the virus could behave in humans.
The experiments in Rotterdam are expected to answer many mysteries about how
the virus might behave in humans, such as the incubation period, how long people
remain infectious, when antibodies are detectable, when fever starts and
subsides, how likely survival would be and whether the virus could be spread
through urine or feces as well as saliva. The tests will also help authorities
determine whether it makes sense to close schools and restrict travel.
Autopsies will be conducted on the infected monkeys to try to determine the
best treatment for the virus.
"We don't know whether this virus is spreading in the entire body or whether
it's just in the lungs," Stohr said, noting that information is key to deciding
which of two available drugs to use to treat it.
"Tamiflu reaches therapeutic levels in many tissues. Relenza does not. It is
only in the lung," he said. "If this virus gets into the brain, the liver and
other parts of the body, then Relenza would be out. We could only use Tamiflu."
"All these questions cannot be answered without doing the proper trials now,"
he added.
Laboratory studies, which are expected to start by the end of March, aim to
understand how likely the bird flu virus is to mate with a human flu variety.
Some of the tests will involve placing the two strains together in bottles to
see how easily they mix and to track which genetic reshuffles occur most
frequently. Each virus has only eight genes, making the number of combinations
manageable to study.
The tests will give clues to what kind of reshuffling is most likely to occur
if a pandemic strain does emerge. Experts would then be able to distinguish
between dangerous combinations and benign ones and respond accordingly.
The next step would be to inject the new hybrid into animals to see how it
behaves. Ferrets would be used first, then perhaps monkeys.
"We are getting ammunition," Stohr said of the experiments. "We don't want to
go into battle without having a reconnaissance mission. We don't want to go into
a pandemic without knowing what the enemy is, and that's what this is all
about."