Bioterrorism: One Monkey Short of 12?

James Cole: Look at them. They’re just asking for it. Maybe the human race deserves to be wiped out.

Jeffrey Goines: Wiping out the human race? That’s a great idea. That’s great. But more of a long-term thing. I mean, first we have to focus on more immediate goals.

– “Twelve Monkeys”

If you’re ever looking for an intelligent science fiction movie that has a timeless and cogent– if terrifying– message, “Twelve Monkeys” is a classic. Replete with great actors like Bruce Willis, Madeleine Stowe and Brad Pitt, “Twelve Monkeys” was produced in 1995 about a convict (James Cole, played by Bruce Willis) living in a post-apocalyptic future who’s sent back in time to stop a deadly plague released by a terrorist organization known as “The Army of the Twelve Monkeys.”

If a remake of the movie were made today, the opening scene might have Bruce Willis’s character returning to alert a governmental committee about a laboratory-constructed virus that kills 60 percent of all its victims. The scene would have him warning of a plan to openly publish the recipe for the pathogen—a virus with all the virulence of the seasonal flu, and vastly more lethal than the 1918 pandemic that killed more than 40 million people. In his testimony, Willis would warn (in colorful language) that open publication of the study would be tantamount to providing Al Qaida with the operational blueprints for a nuclear weapon. Ultimately, though, his concerns would be dismissed “in the interest of scientific research,” and the recipe for the deadly pathogen would be published openly for all to see.

As entertaining as such a remake would be, the story would likely now be dismissed by studio executives for requiring little suspension of disbelief—because all of the story elements are now actually transpiring.

The virus? Avian Flu, or H5N1–a pathogen that the United Nations Coordinator for Influenza warned could cause a pandemic with the potential to kill 150 million people.

The government committee is also real: The National Science Advisory Board for Biosecurity (NSABB)—a panel of experts formed after the 2001 anthrax attacks that advises the government about “dual use” research with legitimate public health purposes, but also potentially used as a bio-terror threat. Paul Keim, current NSABB head, and a world renowned authority on anthrax, recently said of H5N1, “I can’t think of another pathogenic
organism that is as scary as this one. I don’t think anthrax is scary at all compared to this.”

The World Health Organization recently reported that of the 566 confirmed human cases of H5N1 to date; 332 have died. That number has been kept low up to now only because H5N1 does not spread easily between humans. And yet, the possibility that it could mutate to a more virulent form continues to keep government leaders awake at night. Yi Guan, the virologist at Hong Kong University, recently stated what he would do if the highly infectious H1N1 virus combined with the extremely deadly H5N1 virus: “If that happens, I will retire immediately and lock myself in the P3 lab. H5N1 kills half the people it infects.”

In November, Ron Fouchier of the Erasmus Medical Centre in Rotterdam reinforced that a combined H5N1-H1N1 strain of flu is “probably one of the most dangerous viruses you can make.”

He made it anyway.

In an effort that went largely unnoticed until recently, and using very simple steps, Fouchier successfully mutated the H5N1 bird flu virus in his laboratory, creating an airborne form of the virus that spread swiftly among laboratory ferrets–the standard animal model for human influenza research.

Fouchier sent his research paper to the NSABB and the journal, Science. The NSABB quickly branded it too dangerous to publish, demanding entire sections of the report redacted to prevent the recipe for the virus falling into the wrong hands. Keim explained the rationale as a buying-time maneuver, to “slow down the release of the specific information that would enable somebody to reconstruct this virus and do something nefarious.”

But soon, the scientific community mobilized and scuttled the NSABB’s best-laid plans, crying foul over government censorship of science. “It is essential for public health that the full details of any scientific analysis of flu viruses be available to researchers,” said Philip Campbell, editor-in-chief of Nature.

Late last month, after a two-day meeting, the NSABB reversed its decision and supported open publication of the research once the report clarified that not all of the laboratory ferrets died from Fouchier’s H5N1 strain. Still, one- third of the panel members refused to endorse full publication.

“Rational Man” theory has generally been cited to discount the potential for bio-terrorism. With a pathogen’s inability to be precisely employed or controlled as a weapon, viruses have traditionally been viewed as unlikely
weapons of choice. Since the 9-11 attacks, however, lone wolfs like Bruce Ivins, and terror groups like Aum Shinrikyo and Al Qaida have forever shattered those assumptions. With HHS approval secured last week, the
editors-in-chief of Nature and Science plan to publish the research and mutated H5N1 recipe without redaction.