Editor-in-Chief, Chester ‘Trip’ Buckenmaier III, MD, COL, MC, USA

I recently learned through the evening news that a Dutch scientist, Ron Fouchier of the Erasmus Medical Center Rotterdam, Netherlands, has genetically engineered a deadly form of the H5N1 bird flu virus into an easily transmissible form that has the potential to cause lethal human pandemics. The naturally occurring H5N1 bird flu is deadly in humans with a 50% mortality rate in those who have contracted it. Fortunately, this virus exists naturally in a form that is not easily transmissible from person to person.

That has now changed with the research efforts of Fouchier, which was partially funded by the United States. The publication of the recipe for Fouchier’s success is presently being debated. I was at once both horrified and amazed by this story, which easily could serve as a world destroying plot for SPECTRE (SPecial Executive for Counter-intelligence, Terrorism, Revenge and Extortion) in the next Bond film, or the start of a bad zombie movie.

I, like many thousands of American service personnel, had to be vaccinated against the scourge of smallpox (Variola vera) prior to deployment, even though the World Health Organization (WHO) certified the eradication of the smallpox virus in 1979. Despite its eradication through vaccination campaigns, the threat of its use as a biological weapon still exists, as does the smallpox virus in labs within the United States and Russia. It does seem somewhat nonsensical that the United States would fund research that would lead to the publication of instructions for creating an even more devastating disease (the overall mortality rate for smallpox is only 30-35%) and not have this research under tight federal oversight and control. This past December, WHO expressed similar concerns, stating Fouchier’s work carries significant risks. At the same time, WHO also noted that work of this type must continue for the valuable knowledge gained.

Personally, I have to agree that research like Fouchier’s is vital to our understanding of the biology of viruses and how they infect. This understanding can lead to enhanced therapies, methods of prevention and, sadly, weapons of mass destruction. I am amazed at the capabilities and intellect of scientists like Fouchier and colleagues, although I am less enthusiastic about their capability to keep this deadly genie in its bottle. With great intellect comes even greater responsibility. The ethical lessons of our somewhat sordid medical research past (Tuskegee syphilis, Josef Mengele, Cincinnati radiation, etc.) should serve as warnings in our ever more scientifically capable future. The present state of the world does not support the luxury of purely scientific inquiry without an eye toward, and preparation for, the impact of that inquiry. Certainly, Los Alamos Director J. Robert Oppenheimer had similar thoughts with the first successful detonation of a nuclear bomb, as he recalled being reminded of Hindu scripture: “Now I am become Death, the destroyer of worlds.”

In my own lifetime, I have witnessed with delight the many miracles modern science has brought to daily life. As a boy, I watched “Star Trek,” as Captain Kirk used his communicator to speak with Spock; I now carry a more capable device in my cellphone. I can heat my food with a push of a button, reach the other side of the planet in a day, peer inside my patients on a device the size of a laptop and access the world from my computer. Not only have these amazing things enriched our lives, they also can have unexpected and undesirable consequences. My cellphone prevents me from ever really leaving work, the food I microwave is rarely healthy, and I sometimes spend more time on the computer than with my family. I am not complaining, though, because I can manage the mild consequences of these wonderful gifts. I can choose to turn off the cellphone or computer. On the other hand, death from a pandemic caused by the release of a lethal virus through negligence or an act of terror is not manageable. It could quite literally end much that is positive in our world today.

I applaud Ron Fouchier and his team for the intellectuals they are; I only hope they are also the geniuses we all need them to be.

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