Science and the Flu: A Little Learning Is A Dangerous Thing

The first sniffles of flu season are upon us: a friend of mine was struck down, and couldn't join me in attending a science dialogue on Sunday night. This was darkly humorous, as the topic of the evening was pandemics.

Provocatively titled "Is Nature or Man the Most Effective Bioterrorist?", the free event was co-hosted by Wonderfest (The Bay Area Beacon of Science) and Ask A Scientist (a lecture series for curious humans). The speakers hailed from Stanford: two-time Nobel nominee Stanley Falkow, professor of microbiology and immunology, and David Relman, professor of medicine and chair of the Forum on Microbial Threats (really!).

Falkow opened by summarizing the natural history of human-microbe interactions, from chronic "heritage diseases" like herpes--with us since hunter-gatherer days--to acute "crowd diseases" like measles that cropped up (see what I did there?) when people began to settle in larger populations to farm.

Human history has seen some pretty scary pandemics, from the Black Death in Europe to smallpox in the New World. But we survived long enough to invent vaccines and antibiotics, and mortality due to infectious disease has plummeted. The 2009 flu pandemic was a ghost of 1918. Does nature even have a chance anymore of winning "most effective bioterrorist"?

It might. We live in an ever more crowded, ever more connected world, and pathogens adapt to human behavior--right down to evolving antibiotic resistance. In 2007, says Falkow, "I thought nature had done a hell of a good job, and it was going to be hard to beat."

But he changed his mind when he realized that human genetic engineers can do something nature can't: keep the losers.

That may not sound so worrisome, until you realize that hypervirulent pathogens are usually losers. If you kill your hosts off too quickly, you don't get a chance to multiply and spread, and you end up knocking yourself out of the gene pool. Some naturally occurring pathogens have actually evolved control genes that keep their infections mild. Curious scientists have knocked out these genes--and created deadly bugs.

And that was even before all the recent excitement over H5N1, a.k.a bird flu. H5N1 is surprisingly virulent in humans, with a 50-60% mortality rate--but you can't catch it from another human. You have to catch it from a bird. A couple of different scientists wondered if this virus could ever be capable of mammal-to-mammal transmission, and a bit of genetic engineering provided an answer: yes.

Relman presented their research with a kind of restrained horror. Are there some experiments, he asked, that simply shouldn't be done? If so, how do you keep people from doing them?

Regulation is one choice. But Relman says, "I think it's a lost cause--and counterproductive. [Regulation] makes it difficult to evolve and adapt to very fast-moving science." Falkow suggests that the real solution will come from improved dialogue between scientists and the public. "I believe science has a contract with society," he says. "It's a question of whether the public agrees their money should be invested and whether it's safe." Later, he added, "I think one of the great failures of science is the inability to communicate with the public."

The evening's discussion was certainly one step toward turning that failure into success.