Scott McPherson's Web Presence

My favorite punching bag, OIE's head Bernard Vallat, has been conspicuously silent since things went to Hell in a handbasket regarding the global spread of H5N1 a few weeks ago.  Maybe he has been reading his own organization's daily reports of the culling of what is now more than a million Indian chickens.  Or maybe he has been reading about the collapse of the West Bengal poultry industry.  Or maybe he has read the words of prominent virologists who said Vallat's statements were "naive and dangerous -- and widely acknowledged as such among vaccinologists."

That should also serve notice to Dr. Paul Offit, who recently boasted to New York Times' correspondent Donald G. McNeil that, in essence, H5N1 would never go pandemic.  In McNeil's recent fair and balanced article, titled "A Pandemic That Wasn't But Might Be," 

Dr. Paul A. Offit, a vaccine specialist at Children’s Hospital in Philadelphia, was one of those who, he jokes, “dared to be stupid” by bucking the alarmist trend in 2005.

“H5 viruses have been around for 100 years and never caused a pandemic and probably never will,” he said.

But Dr. Offit said he backed all preparedness efforts because he expected another pandemic from an H1, H2 or H3, the subtypes responsible for six previous epidemics, including the catastrophic one in 1918.

“What I worry is that this has been a ‘boy who cried wolf’ phenomenon,” he said. “When the next pandemic comes, people will say, ‘Yeah, yeah, we heard that last time.’ ”

http://www.nytimes.com/2008/01/22/science/22flu.html

Now, I am not personally aware of any record of H5 viruses being typed at all prior to 1959's Scotland discovery.  And if scientists are still divided about what caused the 1890 pandemic --was it an H2 or H3 virus, or something completely different? -- then I don't think Offit can flatly state that H5 has been circulating over the past hundred years.  Don't get me wrong:  I respect Offit, and am currently reading a copy of his book Vaccinated, which chronicles the amazing life of Dr.Maurice Hilleman (see my post, titled Will H2N3 reassortant prove Maurice Hilleman correct? ).

But I respect Dr. Gregory Poland more.  Dr. Poland (pictured) is one of the world's leading vaccinologists -- a peer of Offit's -- and basically runs the vaccine program at the Mayo Clinic.  He is also a world-class expert on the emergence of the H5N1 virus, and is deeply concerned with emerging world events.  You might also recognize Dr. Poland from his appearance on this past summer's BBC docu-drama "Pandemic."  Believe me, he had some choice words for Monsieur Vallat's recent comments about H5N1 being "stable" and H5N1 pandemic fears being "overblown"!! 

I wish someone would ask Dr. Poland for his opinion of Dr. Offit's claim that H5 has been around for a hundred years and will never go pandemic.  Maybe H5 has been around for a thousand years!  How long a virus has been festering in the intestines of flying birds is irrelevant.  It is how long the virus has shown a proclivity for human tracheas and lungs -- that is the question.  And for humanity, H5 in humans -- as far as anyone knows for certain -- has only been around for eleven years.  Not a hundred.  And not a thousand. 

It is like saying that the SARS virus has been hanging around in the blood of civet cats for a hundred years, so why worry?  let's ask the 8,000 people who caught SARS in 2003 -- minus the 800 or so who died -- ask them if it mattered that SARS was no biggie for 99 of those 100 years.

I also appreciated the remarks of Dr. Mike Osterholm, standard bearer in the fight against what he has coined "Pandemic Fatigue." Osterholm, also in the NYT article, "noted that the H3N8 flu found in horses in the 1960s took 40 years to adapt to dogs, but that since 2004 it has spread to kennels all over the country."

Influenza smoulders.  It finds its own way, and on its own timetable. 

Offit belongs to that group of people who believe that only H1, H2 and H3 viruses will ever cause a pandemic -- the theory of recycled pandemic strains of influenza.  Personally, as I mentioned earlier, I am not sure if anyone can say with any degree of certainty that H1, H2 and H3 have caused any more pandemics than the three that have been positively typed by researchers.  After all, influenza has only been typed with certainty in the past fifty years or so.  How anyone can say that these three strains were responsible for 1832, even 1847 or 1890, without supporting genetic material, is a stretch.

Offit's claim in the book about Hilleman is that Hilleman was able to find H2 antibodies in elderly people who lived through the 1890 pandemic.  Therefore, Hilleman claimed (and Offit parrots), the 1890 pandemic must have been an H2 strain.  The 1900 outbreak was an H3, reckoning by the 68-year clock Hilleman/Offit claimed exists (I can find no evidence of a 1900 pandemic, bu the way).  Using that 68-year calculation mechanism, the pandemic of 1847-48 would have been H1.

But wait!  Adding 68 to 1847 equals 1915.  Close enough; let's run with it. And if we know that the 1918 pandemic was an avian flu that jumped straight to humans (we do), as Dr. Jeffrey Taubenberger of the US Armed Forces Pathology Lab genetically proved (with an assist by Dr, Johan Hultin, one of the Unsung Heroes of influenza research), then wasn't that a novel virus?  Wasn't that something that had never been seen before?  Unless that jump had happened before then as well.

So what does this do to the Hilleman/Offit theory if it turns out that this adaptive mutation route is really the cause of the more lethal pandemics, and reassortment , while being a pandemic incubator as well, actually is the more prevalent yet the less likely to kill?  I'll tell you what it does.  It kills it Black Flag Dead.