Maryn McKenna

Journalist and Author

CDC Lab Errors and Their Implications: Congressional Hearing Today

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TEM image of influenza A H7N9, CDC

TEM image of influenza A H7N9, CDC

Leadership of the Centers for Disease Control and Prevention will appear today before the Energy and Commerce Committee of the House of Representatives, to answer questions about the lab accidents with flu and anthrax that the CDC disclosed in its press conference last week.

On deck: CDC Director Dr. Thomas Frieden; Dr. Joseph Henderson, Deputy Director of the CDC’s Office of Security and Emergency Preparedness; staff from the Government Accountability Office and the Animal and Plant Health Inspection Services of USDA; and academic experts.

Tuesday night, the witnesses’ written testimony was placed on the Committee’s webpage. Frieden’s says in part:

First, these incidents should never have happened, and the lack of adequate procedures and oversight that allowed them to happen was totally unacceptable. Although it does not appear that these incidents resulted in any illness, and there was no release of pathogens as a result of either event, this does not excuse what happened.

Second, we will take every step possible to prevent any future incident that could put our laboratory scientists, others in the CDC workforce and the broader community, or the public at risk… I am personally overseeing a series of reforms designed to address these specific incidents – but more broadly, recognizing that our challenge is larger than addressing these two specific incidents, I will oversee the careful and deliberate review of existing, and development of new safety practices at all levels of our Agency…

Third, we will explore the broader implications of these incidents and incorporate the lessons learned from them to proactively prevent future incidents at laboratories across the Nation that work with pathogens.

The two accidents, and especially the flu accident — in which a serious strain of avian flu was mistakenly sent to a poultry-research lab, instead of a mild one — have revived concerns about research currently being pursued, not at the CDC, that soups up flu strains to artificial combinations of transmissibility and virulence. The fear, which I’ve written about here and here, is that a lab accident could allow such manmade flu strains to escape.

In advance of the hearing, a group of scientists who have been critical of the lab-enhanced flu work (generally called “gain of function” or “dual use” research) have banded together as the Cambridge Working Group to put their concerns on the record. [Read more…]

Enhancing Flu In the Lab: Are Accidents Inevitable?

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Image: Shane Byrd (CC), Flickr

Image: Shane Byrd (CC), Flickr

I want to revisit something I wrote about last month — dual-use or gain-of-function flu research — in order to point you to some important recent writing on the issue. To recap, “gain of function” research involves taking a flu strain that already causes severe disease, but is not currently very infectious, and manipulating it in the lab so that it  becomes more infectious. This project is being pursued by two high-profile flu labs, one in the Netherlands and one in Wisconsin, as well as some other smaller labs, and it has been criticized by other researchers as irresponsibly dangerous.

Most of the discussion over this practice has occurred in medical journals. But now one of the critics, Marc Lipsitch of Harvard, has written an op-ed for the New York Times that lays out the questions in everyday language. Lipsitch takes the recent lab error at the Centers for Disease Control and Prevention, which put about 80 employees at risk of inhaling live anthrax bacteria, as evidence that even the most careful, most secure labs make mistakes — and explains how deadly a lab mistake involving an enhanced flu could be.

[Read more…]

What Are the Odds That an Artificially Enhanced Flu Strain Could Escape a Lab?

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Image: Shane Byrd (CC), Flickr

Image: Shane Byrd (CC), Flickr

A controversy that has been brewing for several years in the world of influenza research may ignite again with the publication last week of a new paper that’s worth a read. I haven’t to date written about the controversy, which centers on what’s called “gain of function” research. In the case of flu, what is being gained (via lab manipulation) is the ability for flu to transmit easily from one lab animal to another. The strains being manipulated are already virulent, that is, causing severe illness; and novel — that is, humans have never experienced them before, and so have no immunity to them. Adding transmissible to virulent and novel brings flu into the territory of becoming a potential pandemic strain. That’s where the controversy is, and what this new paper addresses.

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H7N9 Flu, Year Two: What Is Going On?

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Live-poultry market, Shandong, China, 2009. Jonas_in-China (CC), Flickr

Live-poultry market, Shandong, China, 2009. Jonas_in-China, Flickr

Cast your mind back to about this time a year ago. A novel strain of flu, influenza A (H7N9), had emerged in China, in the provinces around Shanghai. International health authorities were deeply concerned, because any new strain of flu bears careful watching — and also because, on the 10th anniversary of the SARS epidemic, no one knew how candid China would be about its cases.

By the time peak season for flu ended in China, there had been 132 cases and 37 deaths from that newest flu strain. But, confounding expectations, the Chinese government was notably open about the new disease’s occurrence, and scientists worldwide were able to ramp up to study it. Still, no one could say whether that flu would be the one to make the always-feared leap to a pandemic strain that might sweep the globe. As with other, earlier, worrisome strains of flu, science could only wait and see whether it might return.

And now it has.
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A Few Ways the Government Shutdown Could Harm Your Health (And the World's)

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image: BMills (CC), Flickr

There’s going to be a lot — a lot — of coverage today on the federal shutdown, what it means and how long it might go on. I thought it might be worth quickly highlighting how it affects the parts of the government that readers here care most about: public health, global health, food safety and the spread of scary diseases.

Most of those government functions are contained within the Cabinet-level Department of Health and Human Services, where 52 percent of the employees have been sent home. So the news is not good.

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The "Road Not (Yet) Taken" On H7N9 Flu — And How Far We've Gotten

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Last week’s New England Journal of Medicine included a thoughtful meditation on the possibility that the new bird flu out of China, H7N9, could become a globe-spanning pandemic — and on how much knowledge is needed before we’ll be able to predict whether it will or not. The authors, all from the US National Institutes of Health, know a fair amount about pandemics: Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases; Dr. David Morens, Fauci’s senior advisor and a medical historian; and Dr. Jeffery Taubenberger, a physician and microbiologist who brought back to the world the viral cause of the worst pandemic: the influenza of 1918, which killed 100 million people.

In various combinations over the past 10 or so years, the three have written a number of papers looking back at the record fro 1918, interrogating its impact, and particularly examining the causes of its extraordinary death toll. So they are probably the perfect authors to write about gaps in knowledge about H7N9.

But aside from its useful examination of the virology, what struck me as most interesting about their paper is how soon it is to be able to write something like this. After all, H7N9 only emerged to public knowledge in late February, and so far has caused 132 cases and 37 deaths, all in eastern China. That these authors could write this paper now is yet another marker, I think, of how different this outbreak is from SARS 10 years ago, as well as how rapidly international public health science can move, if everyone cooperates.

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Transparency Unlocked: More New Saudi Coronavirus Cases Reported Quickly

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In my last post 36 hours ago, I raised questions about Saudi Arabia’s apparent delay in reporting new cases of the novel coronavirus that has been causing low-level unease since last summer. (For the full history of that, check these posts.) So it’s only fair to say that, within 24 hours, the Saudi government behaved very differently with a new report.

The bad news is, the new report is about yet more cases of the novel virus. But the good news is, the report of the new cases was quickly shared internationally, by the government’s Deputy Minister for Public Health, via the international disease-alert mailing news ProMED.

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New Diseases and National Transparency: Who Is Measuring Up?

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I’m still catching up on all the news that happened during the weeks I was away, and I had a food-policy post just about set to go today. And then this happened.

I opened my morning mail to find a note from a private list I subscribe to, published by a company that monitors hazards for businesses with expatriate employees. The note flagged new news from Saudi Arabia:

Saudi Arabia: Seven more case of novel coronavirus reported
Seven people in Al-Ahsa governate in the Eastern province have been confirmed infected with the novel coronavirus. Five have died and the other two are critically ill in intensive care. It is unclear whether there are any links between these cases or whether they are “sporadic” infections. Overall the risk to travellers remains low.

This was odd. You’ll remember the new coronavirus, distantly related to SARS, which surfaced last year in a slow and not well-disclosed manner (for the back story, see these posts from last September, October, November and December). Since the initial reveal last year, there has been very little information released about the virus and whatever illness it might be causing. The World Health Organization has been monitoring the gradual accumulation of cases, but there has been almost nothing published since last fall. In fact, though teams from Columbia University and the Centers for Disease Control and Prevention have been to the Kingdom of Saudi Arabia to help investigate the new illness, neither entity has published anything since those trips were made. And at the point at which I opened my inbox this morning, the WHO’s last update on the new virus had been published on March 26.*

Meanwhile, of course, the infectious disease world has been riveted by the rapid emergence in China of a different virus, the new avian flu H7N9, and many questions have been aimed at whether the Chinese government, which attempted to conceal the emergence of SARS 10 years ago, has learned the lesson of transparency. (I talked about that history, and how the world found out about SARS, in this segment from On the Media a few weeks ago.)

Almost since H7N9 emerged in March, though, the WHO and other bodies have been averring that China is actually doing a good job this time around. And with this overnight news from Saudi, it seems that the questions about disease-outbreak transparency may have been directed at the wrong country.

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Superbug Summer Books:The Fate Of The Species

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I confess: It can get lonely sometimes, being Scary Disease Girl. The universe of people who are deeply invested disease geeks is passionate (thank you, constant readers) but it isn’t that large. And let’s face it, keen interest in things that could bring an end to civilization as we know it — hitherto-unknown pathogens, rampant antimicrobial resistance, nanotechnology run amok — isn’t like to earn repeat invitations to most dinner parties.

So you can imagine how I welcomed the publication of Fred Guterl’s new book, “The Fate of the Species: Why The Human Race May Cause Its Own Extinction And How We Can Stop It” (Bloomsbury), a lean and thoughtful exploration of the possible impact on humankind of scary diseases, and many other potentially  bleak futures. In a series of deeply reported what-if essays, Guterl explores the worst-case scenarios that climate change, species loss, and viruses both real and digital might bring — and what steps we might take now to avert these imagined but plausible outcomes.

A necessary disclosure: Guterl is the executive editor of Scientific American, where I am a columnist on contract. But the book didn’t come to me as a result of that relationship; it was sent to me by a publicist who noticed this books series and had no notion of our connection.

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CDC: First Death From "State Fair Flu"

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The Centers for Disease Control and Prevention today reported the first death from influenza A H3N2 variant (H3N2v), the swine flu strain that has been crossing intermittently from pigs to humans since last year. The victim was an “older adult with multiple underlying health conditions,” according to the CDC, and the Associated Press fills in that the victim was a 61-year-old woman from “central Ohio’s Madison County [who] died this week… after having contact with hogs at the Ross County Fair.” In a statement, the Ohio Department of Health says that she was one of 102 cases so far in the state this year. In total, the CDC says, there have been 289 cases so far this year (with Indiana leading, at 138 cases); in 2011, there were 12. Fifteen people have been hospitalized.

[Read more…]