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|Paradigm Shift Intervention Monitoring||Commentary
November 29, 2004
>>"If the virus reassorts and picks up human influenza genes then it's quite possible the severity could be limited," Peiris said. <<
This is the key issue on the influenza pandemic. The 1918 H1N1 virus gained its lethality by recombining, not reassorting. The same thing has happened with H5N1. The H5N1 in Thailand and Vietnam have already picked up pieces of genes that are not in any other H5N1 isolates. These polymorphisms are found in mammalian isolates such as humans and pigs (and the 1918 isolate had polymorphisms normally found in humans and pigs).
Reassortment can accelerate the effects of recombination, but recombination is the driver of rapid evolution (which can lead to pandemics). Recombination will allow H5N1 to pick up a human receptor binding domain, while leaving the highly lethal remained of H5N1 intact.
Thus, generation of a very lethal H5N1 recombinant with efficient human to human transmission is VERY possible.