Peter Palese has written an excellent opinion piece for the Wall Street Journal on why swine flu is not that scary. His arguments may bring some comfort for those readers of virology blog who are worried about the impact of the new influenza H1N1 strain. Even if you are not worried, the scientific basis for his arguments are compelling and answer some of the many questions I have been receiving in the past week. I can’t think of anyone’s opinion on influenza virus that I value more – and it’s not just because I did my Ph.D. research in his laboratory. He’s an outstanding scientist with balanced, well-informed opinions. Herewith are some excerpts from his piece.
First, Palese reviews the concerns about the new H1N1 viruses:
1. The swine virus belongs to the same H1N1 group as did the 1918 pandemic virus.
2. The swine virus is readily transmitted from human to human. At this point, swine virus isolates have been reported on four continents. The avian H5N1 virus (another virus with pandemic potential) was never proven to readily transmit from person to person; rather, humans were probably infected directly from chickens and these infections required large quantities of virus.
3. The swine virus shows an unusual robustness in emerging outside the normal seasonal period for the virus. Influenza viruses are rarely isolated at the end of April in the northern hemisphere, and winter hasn’t yet started in New Zealand, where several isolates have already been reported.
4. Mutations and/or acquisition of genes derived from other human or animal influenza viruses could make the swine virus into something much more virulent than it is now. Mutations and acquisition of genes are natural processes for influenza viruses against which there are no man-made interventions. Furthermore, these processes (and the extent to which they could enhance virulence) cannot be predicted.
Next, he argues why we should be optimistic:
1. In 1976 there was a an outbreak of an H1N1 swine virus in Fort Dix, New Jersey, which showed human to human transmission but did not go on to become a highly virulent pandemic strain.
2. The presently circulating swine virus is most likely not more virulent than the other seasonal strains we have experienced over the last several years.
3. The current swine virus lacks an important molecular signature (the protein PB1-F2) which was present in the 1918 virus and in the highly lethal H5N1 chicken viruses. If this virulence marker is necessary for an influenza virus to become highly pathogenic in humans or in chickens, then the current swine virus doesn’t have what it takes to become a major killer.
4. Since people have been exposed to H1N1 viruses over many decades, we likely have some cross-reactive immunity against the swine H1N1 virus. While it may not be sufficient to prevent becoming ill, it may very well dampen the impact of the virus on mortality. I would postulate that by virtue of this “herd immunity†even a 1918-like H1N1 virus could never have the horrific effect it had in the past. The most likely outcome is that the current swine virus will become another (fourth) strain of regular seasonal influenza.
5. The landscape of vaccines and anti-influenza drugs has dramatically improved over what it was just a few years ago. Based on what we know of the structure and sequence of the swine virus, these FDA-approved drugs and FDA-licensed vaccines (modified to include the swine strain) would be highly effective against this new virus. Also, present technologies as well as manufacturing capacities will allow us to make sufficient quantities of a swine virus vaccine for the winter 2009-10 season in this country.
In closing, he notes that we have a vastly improved infrastructure to deal with novel emerging diseases:
The preparedness plans developed against the H5N1 influenza threat dramatically improved overall surveillance (we would probably not have learned so fast about the swine virus were it not for these improved capabilities). Major advances have been initiated by our government to develop new and improved manufacturing processes and exciting new vaccine and antiviral approaches are also in the pipeline, and they show promise of tipping the balance in favor of humans against a devious virus. For example, universal influenza vaccines (one long-lasting vaccine against all strains) and broadband antivirals are being developed in our academic laboratories and in innovative small biotech companies. This work has been primarily funded by the NIH and the CDC and it will pay off by diminishing the future impact of influenza on the health of our citizens and on the economy of our country. It is prudent to prepare against swine influenza, but equally important to keep a balanced outlook and an awareness of our current capabilities.
Coming from such a well-informed and experienced source, these arguments are compelling. Please pass them on to anyone you know who might be worried by the recent emergence of the new influenza H1N1 virus.
“The current swine virus lacks an important molecular signature (the protein PB1-F2) which was present in the 1918 virus and in the highly lethal H5N1 chicken viruses. If this virulence marker is necessary for an influenza virus to become highly pathogenic in humans or in chickens, then the current swine virus doesn’t have what it takes to become a major killer.”
Is Dr. Palese taking into account those Mexican isolates that you say haven't been publicized? Or does this matter?
I'm not sure if he has seen the Mexican isolates. I will ask him next
week – I'm doing a special edition of TWiV early in the week.
I would like to direct everyone to the first hour of Science Friday on NPR from 5/1/2009. There is a very good conversation with Dr. Fauci from NIADI that complements the Dr. Palese article. There is also an interesting conversation with Dr. Markel from University of Michigan about the use of quarantine in the 1918 outbreak and the recent measures taken by Mexico and the US. Here is the link, http://www.sciencefriday.com/program/archives/2….
Thank you; I look forward to seeing it. This “omission” strikes me as a huge gap in the public record of this illness and its transmission.
And how do 3 million homeless people in the USA alone fit into this 'nothing to worry about' picture?
http://en.wikipedia.org/wiki/Homelessness_in_th…
This is a very helpful counterpoint to the mainstream media's siren song. I will use it, along with the article by Dr. Larry Brilliant in the WSJ's “Weekend Edition” in my summer and fall homeland security concepts course. In addition to the virology and public health aspects of this, I always insist the class studies (and critically interacts with) the way the media behaves during any emergency. Unfortunately we can't just “do the science” regarding something like this; professionals also have to “do the media.”
This is reassuring:
“Nicholas Grassly of Imperial College London and Andrew Rambaut of the University of Edinburgh, UK, have analysed the rate of spread. Their analysis is based on the small mutations that have accumulated in almost two dozen genetic sequences produced so far, from viruses collected from patients in Mexico and the US.”
http://www.newscientist.com/article/dn17072-fir…
but…..”In contrast to H5N1 bird flu, all the genetic sequences of this H1N1 are being posted on bulletin boards like GISAID”
All?
I would keep my eyes on Brazil. Brazil is poor and pathogenic – like 10 Mexicos.
This is reassuring:
“Nicholas Grassly of Imperial College London and Andrew Rambaut of the University of Edinburgh, UK, have analysed the rate of spread. Their analysis is based on the small mutations that have accumulated in almost two dozen genetic sequences produced so far, from viruses collected from patients in Mexico and the US.”
http://www.newscientist.com/article/dn17072-fir…
but…..”In contrast to H5N1 bird flu, all the genetic sequences of this H1N1 are being posted on bulletin boards like GISAID”
All?
I would keep my eyes on Brazil. Brazil is poor, pathogenic and in the Southern Hemisphere – like 10 Mexicos.
“. The current swine virus lacks an important molecular signature (the protein PB1-F2) which was present in the 1918 virus and in the highly lethal H5N1 chicken viruses. If this virulence marker is necessary for an influenza virus to become highly pathogenic in humans or in chickens, then the current swine virus doesn’t have what it takes to become a major killer.”
Regarding this marker – is it something that was present as well in the early wave of the 1918 virus, which was also considered mild up until August, or was it something that was acquired during its passage through humans?
Do the steps being currently taken reduce the likelihood of sufficient human-to-human transmission to adapt and become more virulent?
It's a good question. The 1918 sequences were obtained from autopsy
material collected in September and November of 1918. Therefore we
can't address the question of whether any changes occurred during
propagation in humans.
We can reduce but not eliminate transmission; therefore selection for
viruses of greater virulence is still possible.
Yes, the Mexico H1N1 sequences have been posted to GISAID. I see 30
isolates so far there.
is the swine flu really scary.? can it kill you the minute you get it.?
do doctors have the swine flue under control.?
Dear Professor Vincent Racaniello.
I have taken the liberty of making a loose translation summation of this article into Japanese for post on the linked blog. Toegether with your interview of Dr. Palese, it is the most informative and reassuring (though cautiously so) article I have come accross. Please would you be so kind as to let me know if you want me to take it down. I have cited you fully. The post will appear here soon.
http://www.butainfuru.com/2009/05/h1n1_2170.html
Thank you for making the translation. I have no problem at all with
you posting the material on your site, as long as virology blog is
cited.
That's really a fantastic post ! I added to my favorite blogs list..
I have been reading your blog last couple of weeks and enjoy every bit good info about swine flu. Thanks
pest control las Vegas
Here is a Chinese edition of this article translated by Prof. Jiaxin YAN:
This article was cited by many websites in China and it is helpful for Chinese to have correct opinion on this pandemic influenza.
美院士帕雷斯:甲型H1N1æµæ„Ÿå±å®³ä¸ä¼šç‰¹åˆ«å¤§
2009å¹´05月05æ—¥10:13 æ¥æºï¼šçޝçƒç§‘å¦ æ–‡ï¼šä¸¥å®¶æ–°
  2009年,5月2日,美国病毒å¦ä¼šä¼šé•¿ã€ç¾Žå›½ç§‘å¦é™¢é™¢å£«ã€å…¨çƒé¡¶çº§æµæ„Ÿä¸“家彼得·帕雷斯(Peter Palese )在美国《åŽå°”街日报》(Wall Street Journalï¼‰æ’°æ–‡è®¤ä¸ºï¼šçŒªæµæ„Ÿï¼ˆç”²åž‹H1N1æµæ„Ÿï¼‰å±å®³ä¸ä¼šç‰¹åˆ«å¤§ï¼ˆåŽŸæ–‡æ ‡é¢˜ä¸ºï¼šWhy Swine Flu Isn't So Scaryï¼Œç›´è¯‘ä¸ºã€Šä¸ºä»€ä¹ˆçŒªæµæ„Ÿä¸æ˜¯é‚£ä¹ˆå¯æ€•》)。
  帕雷斯院士作为全çƒé¡¶çº§æµæ„Ÿä¸“家,多年æ¥ä¸€ç›´å¼ºè°ƒï¼šå¯¹æœªæ¥æµæ„Ÿå¤§æµè¡Œçš„准备工作还没有获得足够的关注。但是在é¢å¯¹å…·ä½“çš„æŸä¸ªæµæ„Ÿæ¯’æ ªé€ æˆå¤§æµè¡Œçš„å¯èƒ½å¨èƒæ—¶ï¼Œä»–å´æ€»æ˜¯èƒ½å‡ç±æ¸Šåšçš„å¦è¯†ï¼Œé€šè¿‡å…¨é¢ç³»ç»Ÿçš„分æžè®ºè¯ï¼Œæå‡ºå¯èƒ½ä¸Žä¼—ä¸åŒã€ä½†æœ€ç»ˆè¢«è¯æ˜Žæ˜¯æ£ç¡®çš„观点。一个最典型的例è¯å°±æ˜¯ï¼šè‡ªä»Ž1997年香港H5N1ç¦½æµæ„Ÿæµè¡Œä»¥æ¥ï¼Œå¸•雷斯院士是H5N1å¯èƒ½å¯¼è‡´æµæ„Ÿå¤§æµè¡Œå‡è¯´çš„æœ€å¼ºçƒˆå对者之一。å余年æ¥çš„äº‹å®žè¯æ˜Žä»–基本上是对的,香港H5N1ç¦½æµæ„Ÿä¸€ç›´æœªé€ æˆå…¨çƒå¤§æµè¡Œã€‚
  ç†è®ºä¸Šï¼ŒçŒªæµæ„Ÿå¼•å‘大æµè¡Œçš„å¯èƒ½æ€§æ¯”ç¦½æµæ„Ÿè¦å¤§å¾—多,帕雷斯也是æŒè¿™ç§è§‚ç‚¹çš„ã€‚è¿™æ¬¡çš„çŒªæµæ„Ÿåœ¨ä»Žé¦–例确诊开始ä¸åˆ°ä¸€ä¸ªæœˆçš„æ—¶é—´å†…,就达到了世界å«ç”Ÿç»„织5级è¦å‘Šçš„æ°´å¹³ï¼Œå¹¶æœ‰å¯èƒ½ä¸Šå‡åˆ°6级(最高级别)。这是å¦è¯æ˜Žäº†å¸•雷斯上述ç†è®ºçš„æ£ç¡®ï¼Œè¡¨æ˜Žç¡®å®žæœ‰ä¸€æ¬¡å±å®³ç›¸å½“于1918å¹´çŒªæµæ„Ÿçš„æ–°çš„çŒªæµæ„Ÿå¤§æµè¡Œå°±è¦åˆ°æ¥å‘¢ï¼Ÿå¸•é›·æ–¯é™¢å£«æ²¡æœ‰å› ä¸ºè‡ªå·±çš„ç†è®ºåˆæ¥å¾—到验è¯è€Œå¾—æ„忘形,ç»è¿‡å†·é™çš„系统分æžï¼Œå¸•雷斯院士在《åŽå°”è¡—æ—¥æŠ¥ã€‹çš„è¿™ç¯‡æ–‡ç« ä¸ä»¥ä»¤äººä¿¡æœçš„ç§‘å¦ä¾æ®ä½œå‡ºæœ€æ–°é¢„测:结果ä¸å¯èƒ½é‚£ä¹ˆç³Ÿï¼Œæˆ‘们完全有ç†ç”±æ›´åŠ ä¹è§‚。
  当然,帕雷斯院士说当å‰çš„çŒªæµæ„Ÿå±å®³ä¸ä¼šç‰¹åˆ«å¤§ï¼Œå¹¶ä¸æ˜¯è¯´å½“å‰ä¸è¦é˜²æŽ§è¿™ç§æµæ„Ÿäº†ã€‚帕雷斯的观点å¯ä»¥æ¢ä¸€ç§æˆ‘们更熟悉的表述方å¼ï¼šæˆ‘们有充分的科å¦ä¾æ®åœ¨æˆ˜ç•¥ä¸Šè—视敌人,但与æ¤åŒæ—¶ï¼Œåœ¨æˆ˜æœ¯ä¸Šä»è¦é‡è§†æ•Œäººã€‚我们应当有充分信心:人类积æžã€ç§‘å¦çš„应对完全å¯ä»¥å°†æµæ„Ÿå¤§æµè¡Œçš„æŸå¤±é™åˆ°æœ€å°ã€‚
  帕雷斯院士多年æ¥ä¸€ç›´æ‹…任美国纽约西奈山医å¦é™¢å¾®ç”Ÿç‰©å¦ç³»ä¸»ä»»ã€‚他从上世纪80年代起就ç»å¸¸è®¿é—®ä¸å›½ï¼ˆåŒ…æ‹¬æ¦æ±‰ï¼‰ã€‚1987ï¼1989å¹´ï¼Œæˆ‘æ›¾åœ¨å¸•é›·æ–¯é™¢å£«çš„å®žéªŒå®¤åšæµæ„Ÿæ–¹é¢çš„åšå£«åŽç ”究。在这篇《åŽå°”è¡—æ—¥æŠ¥ã€‹çš„è¿™ç¯‡æ–‡ç« ä¸ï¼Œå¸•雷斯院士首先对新的H1N1病毒的主è¦ç‰¹ç‚¹è¿›è¡Œäº†æ€»ç»“:
  1.è¿™ç§çŒªç—…毒与1918年的大æµè¡Œç—…毒属于相åŒçš„H1N1亚型。
  2. çŒªç—…æ¯’å¾ˆå®¹æ˜“å®žçŽ°äººé™…é—´ä¼ æ’。目å‰ï¼ŒçŒªç—…æ¯’æ ªå·²å‡ºçŽ°åœ¨4å¤§æ´²ã€‚ä»Žæœªè¯æ˜Žç¦½æµæ„ŸH5N1病毒(å¦ä¸€ç§æœ‰æµè¡Œæ½œåŠ›çš„ç—…æ¯’ï¼‰å®¹æ˜“å®žçŽ°äººé™…é—´ä¼ æ’;人å¯èƒ½æ˜¯ç›´æŽ¥ä»Žé¸¡æ„ŸæŸ“H5N1ç—…æ¯’ï¼Œè¿™ç§æ„ŸæŸ“需è¦å¤§é‡ç—…毒æ‰èƒ½å®žçŽ°ã€‚
  3. è¿™ç§çŒªç—…毒在它们通常出现的å£èŠ‚ä»¥å¤–çš„å£èŠ‚å‡ºçŽ°ï¼Œè¿™æ˜¯ä¸æ£å¸¸çš„ã€‚æµæ„Ÿç—…毒很少在4月底在北åŠçƒåˆ†ç¦»åˆ°ï¼›è€Œç›®å‰åœ¨æ–°è¥¿å…°åˆ™å†¬å£å°šæœªå¼€å§‹ï¼Œä½†åœ¨é‚£é‡Œä¹ŸæŠ¥å‘Šåˆ†ç¦»åˆ°æ•°ä¸ªæ¯’æ ªã€‚
  4. 猪病毒ç»ç”±çªå˜å’Œ/æˆ–ä»Žå…¶ä»–äººæˆ–åŠ¨ç‰©æµæ„Ÿç—…æ¯’èŽ·å–æ–°çš„åŸºå› ï¼Œå¯ä»¥å˜å¾—æ¯”å®ƒä»¬ç›®å‰æ‰€è¡¨çŽ°çš„è‡´ç—…æ€§æ›´å¼ºã€‚å¯¹æµæ„Ÿç—…毒æ¥è®²ï¼Œçªå˜å’ŒèŽ·å–外æ¥åŸºå› 是自然å‘生的过程,其ä¸ä¸å˜åœ¨ä»»ä½•人为的干预。而且,这些进程(以åŠå®ƒä»¬çš„æ¯’æ€§ä¼šå¢žå¼ºåˆ°ä»€ä¹ˆç¨‹åº¦ï¼‰æ— æ³•é¢„æµ‹ã€‚
  帕雷斯还以严密的论è¯ï¼Œå‘Šè¯‰æˆ‘们为什么应该ä¹è§‚:
  1. 1976å¹´ï¼Œåœ¨æ–°æ³½è¥¿å·žè¿ªå…‹æ–¯å ¡æ›¾å‘生过一次H1N1猪病毒的爆å‘,该病毒曾å‘ç”Ÿè¿‡äººé™…é—´ä¼ æ’,但最终并没有æˆä¸ºä¸€ç§éžå¸¸è‡´å‘½çš„大æµè¡Œæ ªã€‚
  2. ç›®å‰æµè¡Œçš„猪病毒与我们在过去若干年里ç»åŽ†è¿‡çš„å…¶ä»–å£èŠ‚æ€§æµæ„Ÿæ¯’æ ªç›¸æ¯”ï¼Œå…¶æ¯’åŠ›å¾ˆå¯èƒ½å¹¶ä¸æ˜¯æ›´å¼ºã€‚
  3. ç›®å‰çš„猪病毒缺ä¹ä¸€ä¸ªé‡è¦çš„åˆ†åæ ‡å¿—(病毒内部蛋白PB1 上的 F2片段), 这是在1918年的病毒和高致病性的H5N1ç¦½æµæ„Ÿç—…毒ä¸éƒ½å˜åœ¨çš„ã€‚å¦‚æžœä¸€ç§æµæ„Ÿç—…æ¯’è¦æƒ³å¯¹äººç±»æˆ–å¯¹é¸¡å…·æœ‰é«˜è‡´ç—…æ€§ï¼Œæ¤æ¯’åŠ›æ ‡å¿—ç¡®å®žæ˜¯å¿…è¦çš„,那么目å‰çš„猪病毒就缺少能æˆä¸ºä¸€ä¸ªä¸»è¦æ€æ‰‹çš„基本æ¡ä»¶ã€‚
  4. å› ä¸ºäººç±»åœ¨è¿‡åŽ»æ•°åå¹´æ¥ä¸€ç›´æš´éœ²äºŽH1N1病毒,我们å¯èƒ½æœ‰ä¸€äº›é’ˆå¯¹çŒªH1N1病毒的交å‰å…疫力。虽然这ç§å…疫力å¯èƒ½ä¸è¶³ä»¥é˜²æ¢æ‚£ç—…,但很å¯èƒ½èƒ½é™ä½Žç—…毒引起的æ»äº¡çŽ‡ã€‚å¸•é›·æ–¯æŽ¨æ–,由于人群ä¸è¿™ç§â€œç¾¤ä½“å…ç–«â€çš„å˜åœ¨ï¼Œå³ä½¿æ˜¯å‡ºçŽ°ç±»ä¼¼1918å¹´H1N1的病毒,它也ç»ä¸å¯èƒ½å¼•å‘它曾ç»å¼•å‘è¿‡çš„é‚£ä¹ˆå¯æ€•çš„åŽæžœã€‚最有å¯èƒ½çš„结果是,当å‰çš„çŒªç—…æ¯’å°†æ¼”å˜æˆä¸ºå¦ä¸€ç§ï¼ˆç¬¬å››ç§ï¼‰å¸¸è§„çš„å£èŠ‚æ€§æµæ„Ÿæ¯’æ ªã€‚
  5 .ç–«è‹—å’ŒæŠ—æµæ„Ÿè¯ç‰©çš„æŠ€æœ¯å¹³å°æ¯”èµ·å‡ å¹´å‰å·²å¤§å¤§æ”¹å–„ã€‚æ ¹æ®æˆ‘们所知é“的猪病毒的结构和åºåˆ—,目å‰ç¾Žå›½é£Ÿå“åŠè¯ç‰©ç®¡ç†å±€å·²æ‰¹å‡†çš„è¯å“和已获注册的疫苗(ç¨ç»ä¿®æ”¹å³å¯é€‚ç”¨äºŽçŒªæµæ„Ÿæ¯’æ ªï¼‰å¯¹ä»˜è¿™ä¸€æ–°çš„ç—…æ¯’å°†æ˜¯éžå¸¸æœ‰æ•ˆçš„。æ¤å¤–,目å‰çš„æŠ€æœ¯ä»¥åŠç”Ÿäº§èƒ½åŠ›å°†ä½¿æˆ‘ä»¬èƒ½å¤Ÿæœ‰è¶³å¤Ÿæ•°é‡çš„猪病毒疫苗在2009-10这个冬å£ä¾›åº”全国。
  最åŽï¼Œä»–指出,我们有大é‡å¾—到改进的基础设施,以应对新出现的疾病。
  针对H5N1ç¦½æµæ„Ÿå¨èƒå®žæ–½çš„å„项计划和预案,大大改进了整个监测系统(如果没有这些改进的监测系统,我们å¯èƒ½ä¸ä¼šè¿™ä¹ˆå¿«å°±å‘现了这次的猪病毒)。最主è¦è¿›å±•æ˜¯æˆ‘ä»¬çš„æ”¿åºœå·²ç€æ‰‹å‘å±•æ–°çš„å’Œæ”¹è¿›çš„åˆ¶é€ å·¥è‰ºï¼Œä»¤äººæŒ¯å¥‹çš„æ–°ç–«è‹—å’ŒæŠ—ç—…æ¯’è¯ç‰©çš„å¼€å‘也æ£åœ¨ä¸æ–å‘å‰æŽ¨è¿›ï¼Œç»“æžœè®©äººç±»åœ¨ä¸Žç‹¡çŒ¾ç—…æ¯’çš„æ–—äº‰ä¸å¾ˆæœ‰å¸Œæœ›å ä¸Šé£Žã€‚ä¾‹å¦‚ï¼Œé€šç”¨æµæ„Ÿç–«è‹—(1 ç§é•¿æœŸå¯¹æ‰€æœ‰æ¯’æ ªæœ‰æ•ˆçš„ç–«è‹—ï¼‰å’Œå¹¿è°±æŠ—ç—…æ¯’è¯ç‰©æ£åœ¨æˆ‘们的实验室和创新的生物技术公å¸å¼€å‘。这项工作的主è¦ç»è´¹ç”±ç¾Žå›½å›½ç«‹å«ç”Ÿç ”究院和疾病预防控制ä¸å¿ƒæä¾›ã€‚è¿™ç§æŠ•å…¥æ˜¯å€¼å¾—çš„ï¼Œç»“æžœå°†å‡å°‘æœªæ¥æµæ„Ÿå¯¹å…¬æ°‘å¥åº·å’Œæ•´ä¸ªå›½æ°‘ç»æµŽçš„å†²å‡»ã€‚æˆ‘ä»¬å½“ç„¶åº”å½“å®¡æ…Žåœ°å‡†å¤‡å¯¹ä»˜çŒªæµæ„Ÿï¼Œä½†åŒæ ·é‡è¦çš„æ˜¯è¦ä¿æŒä¸€ç§å¹³è¡¡çš„心æ€ï¼Œå……分认识我们目å‰å·²å…·å¤‡çš„能力。
ã€€ã€€ï¼ˆæœ¬æ–‡ä½œè€…ï¼šä¸¥å®¶æ–°æ•™æŽˆæ˜¯æ¦æ±‰ç”Ÿç‰©åˆ¶å“ç ”ç©¶æ‰€åšå£«ç”Ÿå¯¼å¸ˆï¼Œä¸»è¦ä»Žäº‹ç‹‚犬病毒ã€äººå…疫缺陷病毒ã€ä¸™åž‹è‚炎病毒检测和诊æ–è¯•å‰‚çš„ç ”ç©¶ã€‚æ–‡ä¸æåˆ°çš„ç¾Žå›½ç§‘å¦é™¢é™¢å£«å¸•雷斯曾是严家新教授的åšå£«åŽå¯¼å¸ˆã€‚)
Here is a Chinese edition of this article translated by Prof. Jiaxin YAN:
This article was cited by many websites in China and it is helpful for Chinese to have correct opinion on this pandemic influenza.
美院士帕雷斯:甲型H1N1æµæ„Ÿå±å®³ä¸ä¼šç‰¹åˆ«å¤§
2009å¹´05月05æ—¥10:13 æ¥æºï¼šçޝçƒç§‘å¦ æ–‡ï¼šä¸¥å®¶æ–°
  2009年,5月2日,美国病毒å¦ä¼šä¼šé•¿ã€ç¾Žå›½ç§‘å¦é™¢é™¢å£«ã€å…¨çƒé¡¶çº§æµæ„Ÿä¸“家彼得·帕雷斯(Peter Palese )在美国《åŽå°”街日报》(Wall Street Journalï¼‰æ’°æ–‡è®¤ä¸ºï¼šçŒªæµæ„Ÿï¼ˆç”²åž‹H1N1æµæ„Ÿï¼‰å±å®³ä¸ä¼šç‰¹åˆ«å¤§ï¼ˆåŽŸæ–‡æ ‡é¢˜ä¸ºï¼šWhy Swine Flu Isn't So Scaryï¼Œç›´è¯‘ä¸ºã€Šä¸ºä»€ä¹ˆçŒªæµæ„Ÿä¸æ˜¯é‚£ä¹ˆå¯æ€•》)。
  帕雷斯院士作为全çƒé¡¶çº§æµæ„Ÿä¸“家,多年æ¥ä¸€ç›´å¼ºè°ƒï¼šå¯¹æœªæ¥æµæ„Ÿå¤§æµè¡Œçš„准备工作还没有获得足够的关注。但是在é¢å¯¹å…·ä½“çš„æŸä¸ªæµæ„Ÿæ¯’æ ªé€ æˆå¤§æµè¡Œçš„å¯èƒ½å¨èƒæ—¶ï¼Œä»–å´æ€»æ˜¯èƒ½å‡ç±æ¸Šåšçš„å¦è¯†ï¼Œé€šè¿‡å…¨é¢ç³»ç»Ÿçš„分æžè®ºè¯ï¼Œæå‡ºå¯èƒ½ä¸Žä¼—ä¸åŒã€ä½†æœ€ç»ˆè¢«è¯æ˜Žæ˜¯æ£ç¡®çš„观点。一个最典型的例è¯å°±æ˜¯ï¼šè‡ªä»Ž1997年香港H5N1ç¦½æµæ„Ÿæµè¡Œä»¥æ¥ï¼Œå¸•雷斯院士是H5N1å¯èƒ½å¯¼è‡´æµæ„Ÿå¤§æµè¡Œå‡è¯´çš„æœ€å¼ºçƒˆå对者之一。å余年æ¥çš„äº‹å®žè¯æ˜Žä»–基本上是对的,香港H5N1ç¦½æµæ„Ÿä¸€ç›´æœªé€ æˆå…¨çƒå¤§æµè¡Œã€‚
  ç†è®ºä¸Šï¼ŒçŒªæµæ„Ÿå¼•å‘大æµè¡Œçš„å¯èƒ½æ€§æ¯”ç¦½æµæ„Ÿè¦å¤§å¾—多,帕雷斯也是æŒè¿™ç§è§‚ç‚¹çš„ã€‚è¿™æ¬¡çš„çŒªæµæ„Ÿåœ¨ä»Žé¦–例确诊开始ä¸åˆ°ä¸€ä¸ªæœˆçš„æ—¶é—´å†…,就达到了世界å«ç”Ÿç»„织5级è¦å‘Šçš„æ°´å¹³ï¼Œå¹¶æœ‰å¯èƒ½ä¸Šå‡åˆ°6级(最高级别)。这是å¦è¯æ˜Žäº†å¸•雷斯上述ç†è®ºçš„æ£ç¡®ï¼Œè¡¨æ˜Žç¡®å®žæœ‰ä¸€æ¬¡å±å®³ç›¸å½“于1918å¹´çŒªæµæ„Ÿçš„æ–°çš„çŒªæµæ„Ÿå¤§æµè¡Œå°±è¦åˆ°æ¥å‘¢ï¼Ÿå¸•é›·æ–¯é™¢å£«æ²¡æœ‰å› ä¸ºè‡ªå·±çš„ç†è®ºåˆæ¥å¾—到验è¯è€Œå¾—æ„忘形,ç»è¿‡å†·é™çš„系统分æžï¼Œå¸•雷斯院士在《åŽå°”è¡—æ—¥æŠ¥ã€‹çš„è¿™ç¯‡æ–‡ç« ä¸ä»¥ä»¤äººä¿¡æœçš„ç§‘å¦ä¾æ®ä½œå‡ºæœ€æ–°é¢„测:结果ä¸å¯èƒ½é‚£ä¹ˆç³Ÿï¼Œæˆ‘们完全有ç†ç”±æ›´åŠ ä¹è§‚。
  当然,帕雷斯院士说当å‰çš„çŒªæµæ„Ÿå±å®³ä¸ä¼šç‰¹åˆ«å¤§ï¼Œå¹¶ä¸æ˜¯è¯´å½“å‰ä¸è¦é˜²æŽ§è¿™ç§æµæ„Ÿäº†ã€‚帕雷斯的观点å¯ä»¥æ¢ä¸€ç§æˆ‘们更熟悉的表述方å¼ï¼šæˆ‘们有充分的科å¦ä¾æ®åœ¨æˆ˜ç•¥ä¸Šè—视敌人,但与æ¤åŒæ—¶ï¼Œåœ¨æˆ˜æœ¯ä¸Šä»è¦é‡è§†æ•Œäººã€‚我们应当有充分信心:人类积æžã€ç§‘å¦çš„应对完全å¯ä»¥å°†æµæ„Ÿå¤§æµè¡Œçš„æŸå¤±é™åˆ°æœ€å°ã€‚
  帕雷斯院士多年æ¥ä¸€ç›´æ‹…任美国纽约西奈山医å¦é™¢å¾®ç”Ÿç‰©å¦ç³»ä¸»ä»»ã€‚他从上世纪80年代起就ç»å¸¸è®¿é—®ä¸å›½ï¼ˆåŒ…æ‹¬æ¦æ±‰ï¼‰ã€‚1987ï¼1989å¹´ï¼Œæˆ‘æ›¾åœ¨å¸•é›·æ–¯é™¢å£«çš„å®žéªŒå®¤åšæµæ„Ÿæ–¹é¢çš„åšå£«åŽç ”究。在这篇《åŽå°”è¡—æ—¥æŠ¥ã€‹çš„è¿™ç¯‡æ–‡ç« ä¸ï¼Œå¸•雷斯院士首先对新的H1N1病毒的主è¦ç‰¹ç‚¹è¿›è¡Œäº†æ€»ç»“:
  1.è¿™ç§çŒªç—…毒与1918年的大æµè¡Œç—…毒属于相åŒçš„H1N1亚型。
  2. çŒªç—…æ¯’å¾ˆå®¹æ˜“å®žçŽ°äººé™…é—´ä¼ æ’。目å‰ï¼ŒçŒªç—…æ¯’æ ªå·²å‡ºçŽ°åœ¨4å¤§æ´²ã€‚ä»Žæœªè¯æ˜Žç¦½æµæ„ŸH5N1病毒(å¦ä¸€ç§æœ‰æµè¡Œæ½œåŠ›çš„ç—…æ¯’ï¼‰å®¹æ˜“å®žçŽ°äººé™…é—´ä¼ æ’;人å¯èƒ½æ˜¯ç›´æŽ¥ä»Žé¸¡æ„ŸæŸ“H5N1ç—…æ¯’ï¼Œè¿™ç§æ„ŸæŸ“需è¦å¤§é‡ç—…毒æ‰èƒ½å®žçŽ°ã€‚
  3. è¿™ç§çŒªç—…毒在它们通常出现的å£èŠ‚ä»¥å¤–çš„å£èŠ‚å‡ºçŽ°ï¼Œè¿™æ˜¯ä¸æ£å¸¸çš„ã€‚æµæ„Ÿç—…毒很少在4月底在北åŠçƒåˆ†ç¦»åˆ°ï¼›è€Œç›®å‰åœ¨æ–°è¥¿å…°åˆ™å†¬å£å°šæœªå¼€å§‹ï¼Œä½†åœ¨é‚£é‡Œä¹ŸæŠ¥å‘Šåˆ†ç¦»åˆ°æ•°ä¸ªæ¯’æ ªã€‚
  4. 猪病毒ç»ç”±çªå˜å’Œ/æˆ–ä»Žå…¶ä»–äººæˆ–åŠ¨ç‰©æµæ„Ÿç—…æ¯’èŽ·å–æ–°çš„åŸºå› ï¼Œå¯ä»¥å˜å¾—æ¯”å®ƒä»¬ç›®å‰æ‰€è¡¨çŽ°çš„è‡´ç—…æ€§æ›´å¼ºã€‚å¯¹æµæ„Ÿç—…毒æ¥è®²ï¼Œçªå˜å’ŒèŽ·å–外æ¥åŸºå› 是自然å‘生的过程,其ä¸ä¸å˜åœ¨ä»»ä½•人为的干预。而且,这些进程(以åŠå®ƒä»¬çš„æ¯’æ€§ä¼šå¢žå¼ºåˆ°ä»€ä¹ˆç¨‹åº¦ï¼‰æ— æ³•é¢„æµ‹ã€‚
  帕雷斯还以严密的论è¯ï¼Œå‘Šè¯‰æˆ‘们为什么应该ä¹è§‚:
  1. 1976å¹´ï¼Œåœ¨æ–°æ³½è¥¿å·žè¿ªå…‹æ–¯å ¡æ›¾å‘生过一次H1N1猪病毒的爆å‘,该病毒曾å‘ç”Ÿè¿‡äººé™…é—´ä¼ æ’,但最终并没有æˆä¸ºä¸€ç§éžå¸¸è‡´å‘½çš„大æµè¡Œæ ªã€‚
  2. ç›®å‰æµè¡Œçš„猪病毒与我们在过去若干年里ç»åŽ†è¿‡çš„å…¶ä»–å£èŠ‚æ€§æµæ„Ÿæ¯’æ ªç›¸æ¯”ï¼Œå…¶æ¯’åŠ›å¾ˆå¯èƒ½å¹¶ä¸æ˜¯æ›´å¼ºã€‚
  3. ç›®å‰çš„猪病毒缺ä¹ä¸€ä¸ªé‡è¦çš„åˆ†åæ ‡å¿—(病毒内部蛋白PB1 上的 F2片段), 这是在1918年的病毒和高致病性的H5N1ç¦½æµæ„Ÿç—…毒ä¸éƒ½å˜åœ¨çš„ã€‚å¦‚æžœä¸€ç§æµæ„Ÿç—…æ¯’è¦æƒ³å¯¹äººç±»æˆ–å¯¹é¸¡å…·æœ‰é«˜è‡´ç—…æ€§ï¼Œæ¤æ¯’åŠ›æ ‡å¿—ç¡®å®žæ˜¯å¿…è¦çš„,那么目å‰çš„猪病毒就缺少能æˆä¸ºä¸€ä¸ªä¸»è¦æ€æ‰‹çš„基本æ¡ä»¶ã€‚
  4. å› ä¸ºäººç±»åœ¨è¿‡åŽ»æ•°åå¹´æ¥ä¸€ç›´æš´éœ²äºŽH1N1病毒,我们å¯èƒ½æœ‰ä¸€äº›é’ˆå¯¹çŒªH1N1病毒的交å‰å…疫力。虽然这ç§å…疫力å¯èƒ½ä¸è¶³ä»¥é˜²æ¢æ‚£ç—…,但很å¯èƒ½èƒ½é™ä½Žç—…毒引起的æ»äº¡çŽ‡ã€‚å¸•é›·æ–¯æŽ¨æ–,由于人群ä¸è¿™ç§â€œç¾¤ä½“å…ç–«â€çš„å˜åœ¨ï¼Œå³ä½¿æ˜¯å‡ºçŽ°ç±»ä¼¼1918å¹´H1N1的病毒,它也ç»ä¸å¯èƒ½å¼•å‘它曾ç»å¼•å‘è¿‡çš„é‚£ä¹ˆå¯æ€•çš„åŽæžœã€‚最有å¯èƒ½çš„结果是,当å‰çš„çŒªç—…æ¯’å°†æ¼”å˜æˆä¸ºå¦ä¸€ç§ï¼ˆç¬¬å››ç§ï¼‰å¸¸è§„çš„å£èŠ‚æ€§æµæ„Ÿæ¯’æ ªã€‚
  5 .ç–«è‹—å’ŒæŠ—æµæ„Ÿè¯ç‰©çš„æŠ€æœ¯å¹³å°æ¯”èµ·å‡ å¹´å‰å·²å¤§å¤§æ”¹å–„ã€‚æ ¹æ®æˆ‘们所知é“的猪病毒的结构和åºåˆ—,目å‰ç¾Žå›½é£Ÿå“åŠè¯ç‰©ç®¡ç†å±€å·²æ‰¹å‡†çš„è¯å“和已获注册的疫苗(ç¨ç»ä¿®æ”¹å³å¯é€‚ç”¨äºŽçŒªæµæ„Ÿæ¯’æ ªï¼‰å¯¹ä»˜è¿™ä¸€æ–°çš„ç—…æ¯’å°†æ˜¯éžå¸¸æœ‰æ•ˆçš„。æ¤å¤–,目å‰çš„æŠ€æœ¯ä»¥åŠç”Ÿäº§èƒ½åŠ›å°†ä½¿æˆ‘ä»¬èƒ½å¤Ÿæœ‰è¶³å¤Ÿæ•°é‡çš„猪病毒疫苗在2009-10这个冬å£ä¾›åº”全国。
  最åŽï¼Œä»–指出,我们有大é‡å¾—到改进的基础设施,以应对新出现的疾病。
  针对H5N1ç¦½æµæ„Ÿå¨èƒå®žæ–½çš„å„项计划和预案,大大改进了整个监测系统(如果没有这些改进的监测系统,我们å¯èƒ½ä¸ä¼šè¿™ä¹ˆå¿«å°±å‘现了这次的猪病毒)。最主è¦è¿›å±•æ˜¯æˆ‘ä»¬çš„æ”¿åºœå·²ç€æ‰‹å‘å±•æ–°çš„å’Œæ”¹è¿›çš„åˆ¶é€ å·¥è‰ºï¼Œä»¤äººæŒ¯å¥‹çš„æ–°ç–«è‹—å’ŒæŠ—ç—…æ¯’è¯ç‰©çš„å¼€å‘也æ£åœ¨ä¸æ–å‘å‰æŽ¨è¿›ï¼Œç»“æžœè®©äººç±»åœ¨ä¸Žç‹¡çŒ¾ç—…æ¯’çš„æ–—äº‰ä¸å¾ˆæœ‰å¸Œæœ›å ä¸Šé£Žã€‚ä¾‹å¦‚ï¼Œé€šç”¨æµæ„Ÿç–«è‹—(1 ç§é•¿æœŸå¯¹æ‰€æœ‰æ¯’æ ªæœ‰æ•ˆçš„ç–«è‹—ï¼‰å’Œå¹¿è°±æŠ—ç—…æ¯’è¯ç‰©æ£åœ¨æˆ‘们的实验室和创新的生物技术公å¸å¼€å‘。这项工作的主è¦ç»è´¹ç”±ç¾Žå›½å›½ç«‹å«ç”Ÿç ”究院和疾病预防控制ä¸å¿ƒæä¾›ã€‚è¿™ç§æŠ•å…¥æ˜¯å€¼å¾—çš„ï¼Œç»“æžœå°†å‡å°‘æœªæ¥æµæ„Ÿå¯¹å…¬æ°‘å¥åº·å’Œæ•´ä¸ªå›½æ°‘ç»æµŽçš„å†²å‡»ã€‚æˆ‘ä»¬å½“ç„¶åº”å½“å®¡æ…Žåœ°å‡†å¤‡å¯¹ä»˜çŒªæµæ„Ÿï¼Œä½†åŒæ ·é‡è¦çš„æ˜¯è¦ä¿æŒä¸€ç§å¹³è¡¡çš„心æ€ï¼Œå……分认识我们目å‰å·²å…·å¤‡çš„能力。
ã€€ã€€ï¼ˆæœ¬æ–‡ä½œè€…ï¼šä¸¥å®¶æ–°æ•™æŽˆæ˜¯æ¦æ±‰ç”Ÿç‰©åˆ¶å“ç ”ç©¶æ‰€åšå£«ç”Ÿå¯¼å¸ˆï¼Œä¸»è¦ä»Žäº‹ç‹‚犬病毒ã€äººå…疫缺陷病毒ã€ä¸™åž‹è‚炎病毒检测和诊æ–è¯•å‰‚çš„ç ”ç©¶ã€‚æ–‡ä¸æåˆ°çš„ç¾Žå›½ç§‘å¦é™¢é™¢å£«å¸•雷斯曾是严家新教授的åšå£«åŽå¯¼å¸ˆã€‚)