After spending more time than I wished “defending” WHO against what I considered a particular kind of scurrilous attack (it also seemed to raise the hackles of some unintended as targets, but the dialog with them was at least rational) — after all that, I now have to turn around and complain about WHO (again). Let me be constructive and offer their spokesperson, John Rainford (or whoever writes the statements he mouths), a little biology lesson. A mutation of a virus is a technical term that describes a replicable change in the sequence of bases that constitute the virus’s genetic blueprint and its heritable material (for influenza, RNA). The genetic blueprint is one of the main (but not only) determinants of how the virus behaves and spreads in a population of potential hosts — like birds or us. If you want to see if one has occurred you look at the sequence of bases in the virus’s RNA (or, almost equivalently, the sequence of amino acids in proteins coded for by the RNA). If you want to know what the mutations mean, you also have to know quite a bit about the biology of the virus in a particular host. We don’t know most of what we would like to know about that part of the picture for influenza A, especially the subtype of influenza/A we are most worried about these days, subtype H5N1. Why the lesson?
The World Health Organisation on Friday ruled out any mutation of the potentially fatal H5N1 strain of the bird flu virus after a case of inter-human transmission of bird flu may have been detected in Pakistan.
“There is no suggestion that the virus has changed into a form that poses a broader risk,” WHO spokesman John Rainford told AFP. “If that had been the case, we would have witnessed more cases of human transmission.”
Rainford said that the genetic sequencing of the virus involved in the latest case was being continued. (Agence France Presse)
What’s wrong with this? Suppose (for the sake of argument) it takes two changes to turn a virus into one that “poses a broader risk” and only one has occurred in this case. We wouldn’t know this by seeing if there were more cases. We would only know this if we looked at the sequence and further, we knew what to look for (which two changes to track). It isn’t clear that the viral sequence in this case has been examined completely (and we hope that when it is examined, the sequence will be deposited immediately into a publicly accessible database like GenBank). It is also quite clear we don’t know what to look for, so a categorical statement that “a mutation” has been “ruled out” isn’t true and cannot be true at this point.
It’s bad enough that WHO doesn’t release information it can release quickly enough; or that there is some information it cannot release or chooses not to release at all but doesn’t tell us why it cannot release it or chooses not to release it.
It’s worse that too often the information it does release is wrong.