Saint Louis University influenza researcher comments in Nov. 24 issue
An article by Robert Belshe, M.D., of Saint Louis University School of Medicine in this weeks New England Journal of Medicine reviews recent "spectacular achievements of contemporary molecular biology" that hold great importance as the world prepares for a possible flu pandemic.
These achievements, including a recent genetic sequencing and recreation of the virus from the 1918 flu pandemic, "may enable us to track viruses years before they develop the capacity to replicate with high efficiency in humans," Belshe writes.
Belshe said the question of the moment involves which mechanism a future pandemic could involve. "Are we going to see an event like 1918, an avian virus adapting to man, or will it be an event like 1957 or 1968, where an avian virus contributes some genetic material by mixing in with a current strain of the human virus?" Belshe says. "We dont know what will happen or when it will happen, but we know it will happen."
And although it cant be said for sure whether the current avian flu virus can adapt readily to the point where human-to-human transmission is possible, the recent research findings do provide some clues as to what genetic changes are necessary for such an event to occur. In fact, several additional genetic changes must occur in the currently circulating bird flu viruses before these viruses will begin to spread efficiently from person to person and this can be monitored closely by scientists.
"Taubenberger estimated that based upon the rate of evolution, the 1918 epidemic had circulated in man since 1900," Belshe says. "So it took a while to become highly efficient as a pandemic virus."
A copy of the full article can be found in the Nov. 24 issue of the New England Journal of Medicine (2209-2211).
Belshe is director of the Center for Vaccine Development at Saint Louis University School of Medicine. He has conducted research related to influenza for more than two decades, and he has previously published articles in the New England Journal of Medicine on the influenza anti-viral Tamiflu, on the nasal spray influenza vaccine FluMist, and last fall on intradermal administration of flu vaccinations. He has authored dozens of papers on influenza that have been covered in various scholarly journals, including a 1998 commentary in The Lancet article that warned of a coming global flu pandemic and of the necessity of preparing for one.
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