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Paradigm Shift Intervention Monitoring
News On H5N1 Guizhou Case
On Sunday, Chinese censors generally blocked Internet users from reading reports of the latest death.
The above comments describe censorship of news on the H5N1 case (39M) from Guiyang, Guizhou who had no reported contact with poultry, suggesting that the case would be linked to clade 220.127.116.11 as seen in the recent case from Shenzhen, who also had no reported contact with poultry. The sequences from the Shenzhen case, A/Guangdong-Shenzhen/1/2011, were released less than a week after collection, and the HA sequence had a number of receptor binding domain changes. The two changes reported in the Gharbia cluster, V223I and M230I, were present, as expected. However, the sequence also had S227R as well asQ196K, raising concerns that the combination of changes could be approaching the five changes reported in the paper censored by Science.
That paper described five changes on two genes and four of the five changes have already been found in published sequences. One of those changes is PB1 E627K, which was not in the Shenzhen clade 18.104.22.168, but was present in the most recent H5N1 sequence from cases in Cambodia, where all 8 of the cases in 2011 have died, as has the only case in 2012. That case also had S227N, which is likely to be one of the HA changes in the aerosol version of H5N1 that transmits in ferrets.
The co-circulation of the above changes raises concerns that new combinations may be generated by recombination, leading to enhanced transmission, which may or may not match the changes described in the censored paper at Science.
It is unclear if the censorship of news on the most recent case will impact release of sequences from the Guizhou case. Similarly, Indonesia quickly released sequences from the Bali cluster, which also had receptor binding domain changes. That cluster was followed by a cluster from North Jakarta. And sequences from that cluster have not been released, raising concerns that the censorship of the papers and nature and Science will have a chilling effect on transparency and lead to more hidden sequences, as it becomes increasingly clear that H5N1 currently in circulation is very close to efficient transmission.
The natural versions pose a far greater hazard than some unnamed rogue state or terrorist who are said to benefit from the release of the five changes describe in the Science paper. Since it is already known that 4 of 5 changes are already in circulation in a published sequence, the creation of a transmissible H5N1 is a trivial task, although the value of such bioweapon is far from clear, since influenza cannot be controlled, and effects on rogue nations would be significant.
Thus, the censorship by Nature and Science continues to endanger the world’s health, and the lack of understanding of influenza evolution by the NSABB is glaring. Therefore replacement of the current board with one more knowledgeable about influenza evolution should be actively pursued.