Table of Contents:

Foreword

Introduction

I. Storm Gathering

1. 1918

2. Master of Metamorphosis

3. H5N1

4. Playing Chicken

5. Worse Than 1918?

6. When, Not If

II. When Animal Viruses Attack

1. The Third Age

2. Man Made

3. Livestock Revolution

4. Tracing the Flight Path

5. One Flu Over the Chicken's Nest

6. Coming Home to Roost

7. Guarding the Henhouse

III. Pandemic Preparedness

1. Cooping Up Bird Flu

2. Race Against Time

3. Tamiflu

IV. Surviving the Pandemic

1. Don't Wing It

2. Our Health in Our Hands

3. Be Prepared

V. Preventing Future Pandemics

1. Tinderbox

2. Reining in the Pale Horse

Topics

References 1-3,199

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Dr. Jeffery Taubenberger

Sequencing the 1918 virus is one thing; bringing it back to life is something else. Using a new technique called “reverse genetics,” Taubenberger teamed up with groups at Mount Sinai and the U.S. Centers for Disease Control and Prevention (CDC) and set out to raise it from the dead.122 Using the genetic blueprint provided by Lucy’s frozen lungs, they painstakingly recreated each of the genes of the virus, one letter at a time. Upon completion, they stitched each gene into a loop of genetically manipulated bacterial DNA and introduced the DNA loops into mammalian cells.123 The 1918 virus was reborn.

Ten vials of virus were created, each containing 10 million infectious virus particles.124 First they tried infecting mice. All were dead in a matter of days. “The resurrected virus apparently hasn’t lost any of its kick,” Taubenberger noted. Compared to a typical non-lethal human flu strain, the 1918 virus generated 39,000 times more virus particles in the animals’ lungs. “I didn’t expect it to be as lethal as it was,” one of the co-authors of the study remarked.125

The experiment was hailed as a “huge breakthrough,”126 a “tour de force.”127 “I can’t think of anything bigger that’s happened in virology for many years,” cheered one leading scientist.128 Not knowing the true identity of the 1918 flu had been “like a dark angel hovering over us.”129

Critics within the scientific community, however, wondered whether the box Taubenberger had received from Hultin might just as well have been addressed to Pandora. One scientist compared the research to “looking for a gas leak with a lighted match.”130 “They have constructed a virus,” one biosecurity specialist asserted, “that is perhaps the most effective bioweapon known.”131 “This would be extremely dangerous should it escape, and there is a long history of things escaping,” warned a member of the Federation of American Scientists’ Working Group on Biological Weapons.132 Taubenberger and his collaborators were criticized for using only an enhanced Biosafety Level 3 lab to resurrect the virus rather than the strictest height of security, Level 4. Critics cite three recent examples where deadly viruses had escaped accidentally from high-security labs.133

In 2004, for example, a strain of influenza that killed a million people in 1957 was accidentally sent to thousands of labs around the globe within a routine testing kit. Upon learning of the error, the World Health Organization called for the immediate destruction of all the kits. Miraculously, none of the virus managed to escape any of the labs. Klaus Stöhr, head of the World Health Organization’s global influenza program, admitted that it was fair to say that the laboratory accident with the unlabeled virus could have started a flu pandemic. “If many bad-luck things had come together, it could have really caused a global health emergency.”134 “We can’t have this happen,” remarked Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “Who needs terrorists or Mother Nature, when through our own stupidity, we do things like this?”135

Not only was the 1918 virus revived, risking an accidental release from the lab, but in the interest of promoting further scientific exploration, Taubenberger’s group openly published the entire viral genome on the internet, letter for letter. This was intended to allow other scientists the opportunity to try to decipher the virus’s darkest secrets. The public release of the genetic code, however, meant that rogue nations or bioterrorist groups had been afforded the same access. “In an age of terrorism, in a time when a lot of folks have malicious intent toward us, I am very nervous about the publication of accurate [gene] sequences for these pathogens and the techniques for making them,” said a bioethicist at the University of Pennsylvania.136 “Once the genetic sequence is publicly available,” explained a virologist at the National Institute for Biological Standards and Control, “there’s a theoretical risk that any molecular biologist with sufficient knowledge could recreate this virus.”137

Even if the 1918 virus were to escape, there might be a graver threat waiting in the wings. As devastating as the 1918 pandemic was, on average the mortality rate was less than 5%.138 The H5N1 strain of bird flu virus now spreading like a plague across the world currently kills about 50% of its known human victims, on par with some strains of Ebola,139 making it potentially ten times as deadly as the worst plague in human history.140,141 “The picture of what the [H5N1] virus can do to humans,” said the former chief of infectious disease at Children’s Hospital in Boston, “is pretty gruesome in terms of its mortality.”142

Leading public health authorities, from the U.S. Centers for Disease Control and Prevention to the World Health Organization, fear that this bird flu virus is but mutations away from spreading efficiently though the human population, triggering the next pandemic. “The lethal capacity of this virus is very, very high; so it’s a deadly virus that humans have not been exposed to before. That’s a very bad combination,” says Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University.143 Scientists have speculated worst-case scenarios in which H5N1 could end up killing a billion144 or more145 people around the globe. “The only thing I can think of that could take a larger human death toll would be thermonuclear war,” said Council on Foreign Relations senior fellow Laurie Garrett.146