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【medical-news】【资讯翻译】H5N1高传播性改造毒株引发科学发现与公众安全之间的讨论

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Newly Engineered Highly Transmissible H5N1 Strain Ignites Controversy About Balancing Scientific Discovery And Public Safety

Scientists have engineered a new strain of H5N1 (commonly known as bird flu) to be readily transmitted between humans. Two perspectives being published early online in Annals of Internal Medicine, the flagship journal of the American College of Physicians, raise concerns about if and how this research should be continued, and how the data should be shared for the benefit of public health.

The currently circulating H5N1 virus has an extremely high case-fatality rate, killing about 60 percent of the over 500 confirmed human cases. However, unlike seasonal flu, to date H5N1 has not easily spread between humans. Recently, two scientific teams (not associated with the Annals perspectives authors) engineered the H5N1 virus to make it readily transmissible between ferrets. This means that it may be able to make it easily transmissible between humans as well. Controversy has emerged about the safety and appropriateness of this research.

The National Science Advisory Board for Biosecurity (NSABB) has recommended that the H5N1 research be published, but with significant redactions. Specifically, journals should publish the work without detailed methodology, to reduce the risk of replication and purposeful misuse. This recommendation has divided the scientific community into those who are for censorship, and those who oppose it.

In the first Annals perspective, Thomas V. Inglesby, MD, CEO and Director of the Center for Biosecurity of University of Pittsburgh Medical Center, writes that the potential consequences of an engineered human transmissible H5N1 strain are stunning. If the newly engineered strain were to escape the laboratory and spread as widely as seasonal flu, it could endanger the lives of hundreds of millions of persons.

Whether the virus escapes the lab by accident or on purpose, the highly contagious and deadly nature of the mutant strain could result in catastrophe. The work was done to increase scientific knowledge of H5N1. But there is no scientific evidence that a strain like the one developed in the laboratory will ever occur naturally. Dr. Inglesby suggests that the harms of the research therefore outweigh the benefits.

"If we are asking society to take the substantial and unprecedented risks associated with a human-transmissible H5N1 strain with a nearly 60 percent case-fatality rate, we had better have a compelling, concrete, and realistic public health justification for it," Dr. Inglesby writes. If experimentation must continue, he recommends very restricted use, like the approach that has been taken with smallpox.

Andrew T. Pavia, MD, Chief of the Division of Pediatric Infectious Diseases at the University of Utah Health Sciences Center and Primary Children's Hospital, authored the second Annals perspective on the topic.

Dr. Pavia, argues that the H5N1 virus may not be as easy to transmit between humans as some speculate. With regard for the use of H5N1 as a bioweapon, Dr. Pavia suggests that the scenario may be unlikely. To manipulate H5N1 as a weapon, the terrorist would need substantial scientific skill and knowledge of precise methods used in the studies.

He writes that with proper safeguards, these and future studies should proceed and can increase critical scientific understanding of influenza. Currently, there is not a transparent and thoughtful mechanism to ensure the provision of details only to those with a legitimate need for the data and to decide who those people are. Dr. Pavia thus generally agrees with the approach taken by the NSABB and argues creating more dangerous pathogens in a laboratory has its purpose. According to Dr. Pavia, "We must have a careful and balanced approach that is neither too timid in permitting the performance and sharing of critical research nor too naive in confronting the biosecurity issues posed by that research."

Meanwhile the investigators themselves have announced a 60 day self-mortorium on their research while debate continues.

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2012-01-30 13:39 浏览 : 2299 回复 : 9

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认领本文翻译，48小时内未完成，请其他战友认领！

2012-01-30 13:40

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Newly Engineered Highly Transmissible H5N1 Strain IgnitesControversy About Balancing Scientific Discovery And Public Safety
新近改造的高传染性H5N1禽流感病毒株引发了如何均衡科学发现和公共安全的争论。

Scientists have engineered a new strain of H5N1 (commonly known as bird flu) tobe readily transmitted between humans. Two perspectives being published earlyonline in Annals of Internal Medicine, the flagship journal of the AmericanCollege of Physicians, raise concerns about if and how this research should becontinued, and how the data should be shared for the benefit of public health.
科学家们已经改造出了一种新的可以轻易在人类之间传播的H5N1（通常被称为禽流感）病毒株。两篇研究评述早前发表在《网络医学年报》，该期刊是美国内科医生学院的一流期刊，引发了是否应该以及如何继续进行此项研究，及该项研究数据为了公共健康利益着想，如何分享。

The currently circulating H5N1 virus has an extremely high case-fatality rate,killing about 60 percent of the over 500 confirmed human cases. However, unlikeseasonal flu, to date H5N1 has not easily spread between humans. Recently, twoscientific teams (not associated with the Annals perspectives authors)engineered the H5N1 virus to make it readily transmissible between ferrets.This means that it may be able to make it easily transmissible between humansas well. Controversy has emerged about the safety and appropriateness of thisresearch.
目前流行的H5N1病毒感染有着极高的病死率，500例确诊的人类病例中有近60%死于该疾病。然而，不同于季节性流感，到目前为止H5N1病毒不能在人类之间轻易传播。最近，两个科研团队（和网络医学年报研究评述作者没有关联）改造了H5N1病毒株，使之能够在雪貂（一种哺乳动物）之间轻易传播。这也就意味着可能让H5N1病毒在人类之间轻易传播。关于此项研究的安全性和合适性的争论已经浮出水面。

The National Science Advisory Board for Biosecurity (NSABB) has recommended thatthe H5N1 research be published, but with significant redactions. Specifically,journals should publish the work without detailed methodology, to reduce therisk of replication and purposeful misuse. This recommendation has divided thescientific community into those who are for censorship, and those who opposeit.
国国家生物安全科学咨询委员会（NSABB）建议此项H5N1研究在大幅度编辑的前提下发表。NSABB特别指出，科学期刊公布该项研究是不应该包含详尽的方法学内容，以降低复制该项研究的风险和故意的不正当使用。NSABB的此项建议已经让科学界分成两派，一派支持审查制度，另一派反对审查制度。

In the first Annals perspective, Thomas V. Inglesby, MD, CEO and Director ofthe Center for Biosecurity of University of Pittsburgh Medical Center, writesthat the potential consequences of an engineered human transmissible H5N1strain are stunning. If the newly engineered strain were to escape thelaboratory and spread as widely as seasonal flu, it could endanger the lives ofhundreds of millions of persons.
在第一份年报研究评述中，Thomas V.Inglesby,医学博士，匹兹堡大学医学中心生物安全中心首席执行官和总经理，指出改造后的可在人类之间传播H5N1病毒株的潜在后果将是振聋发聩的。如果该新近改造的H5N1病毒株逃离了实验室，和季节性流感一样广泛传播，可以危及亿万人的生命。

Whether the virus escapes the lab by accident or on purpose, the highlycontagious and deadly nature of the mutant strain could result in catastrophe.The work was done to increase scientific knowledge of H5N1. But there is noscientific evidence that a strain like the one developed in the laboratory willever occur naturally. Dr. Inglesby suggests that the harms of the researchtherefore outweigh the benefits.
不管该病毒株是意外或者故意逃离实验室的，变异病毒株的高传染性和致命的本质可以导致极大的灾难。此项科研工作是为了增加对H5N1的科学知识。但没有证据显示实验室中改造出的病毒株会在自然条件下发生。Inglesby博士因此提示此项研究的害处超过了其好处。

"If we are asking society to take the substantial and unprecedented risksassociated with a human-transmissible H5N1 strain with a nearly 60 percentcase-fatality rate, we had better have a compelling, concrete, and realisticpublic health justification for it," Dr. Inglesby writes. Ifexperimentation must continue, he recommends very restricted use, like theapproach that has been taken with smallpox.
如果我们要求整个人类社会为有着60%死亡率，可在人类间传播的H5N1病毒株去承担实质的，史无前例的风险，我们最好对此病毒株有一个急切的，具体的和现实的公共健康辩护说辞。Inglesby博士如是写道。他建议，如果此项研究一定要继续，应该限制病毒株的使用，就象针对天花所采取的方法。

Andrew T. Pavia, MD, Chief of the Division of Pediatric Infectious Diseases atthe University of Utah Health Sciences Center and Primary Children's Hospital,authored the second Annals perspective on the topic.
Andrew T. Pavia，医学博士，犹他大学健康科学中心儿童医院的儿童传染病部主任，是第二份年报关于此议题的研究评述的作者。

Dr. Pavia, argues that the H5N1 virus may not beas easy to transmit between humans as some speculate. With regard for the useof H5N1 as a bioweapon, Dr. Pavia suggests that the scenario may be unlikely.To manipulate H5N1 as a weapon, the terrorist would need substantial scientificskill and knowledge of precise methods used in the studies.
Pavia博士争论到H5N1病毒也许没有有些人怀疑的那样，很容易在人类之间传播。关于H5N1变异株会被用作生物武器，Pavia博士认为这样的场景不太可能。要操控H5N1变异株作为武器，恐怖分子需要实质性的科学技术，和研究中所用到的方法的精准知识。

He writes that with proper safeguards, these and future studies should proceedand can increase critical scientific understanding of influenza. Currently,there is not a transparent and thoughtful mechanism to ensure the provision ofdetails only to those with a legitimate need for the data and to decide whothose people are. Dr. Pavia thus generally agrees with the approach taken bythe NSABB and argues creating more dangerous pathogens in a laboratory has itspurpose. According to Dr. Pavia, "We must have a careful and balancedapproach that is neither too timid in permitting the performance and sharing ofcritical research nor too naive in confronting the biosecurity issues posed by thatresearch."
Pavia写道有合适的安保措施，这些现在和将来的关于H5N1的研究应该继续进行，以此增加对流感的重要科学认识。目前，没有一个透明和周全的机制确保只向有合法需求的人们提供该项研究的细节和如何决定合法的人选。Pavia博士因此大体上同意美国国家生物安全科学咨询委员会（NSABB）所采取的方法，同时争论到在实验室创造更加危险的病原体有它自身的目的。居Pavia博士所说：我们必须有一个谨慎和平衡的方法，既做到不要太胆小以致不敢批准试验和分享重要研究，又不会因为研究稚嫩，和生物安全议题相冲突。

Meanwhile the investigators themselves have announced a 60 day self-moratorium on their research while debate continues.
于此同时，研究者自身已经宣布在争论仍在继续的情况下，暂停研究60天。

2012-01-30 15:26

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wearedoctors 编辑于 2012-02-03 13:55

• 想嫁兵哥哥援鄂护士被指学历造假，曾就读卫校：读一年退学了

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编译：新近改造的高传染性H5N1禽流感病毒株引发了如何均衡科学发现和公共安全的争论。科学家们已经改造出了一种新的可以轻易在人类之间传播的H5N1（通常被称为禽流感）病毒株。两篇研究评述早前发表在《网络医学年报》，该期刊是美国内科医生学院的一流期刊，引发了是否应该以及如何继续进行此项研究，及该项研究数据为了公共健康利益着想，如何分享。目前流行的H5N1病毒感染有着极高的病死率，500例确诊的人类病例中有近60%死于该疾病。然而，不同于季节性流感，到目前为止H5N1病毒不能在人类之间轻易传播。最近，两个科研团队（和网络医学年报研究评述作者没有关联）改造了H5N1病毒株，使之能够在雪貂（一种哺乳动物）之间轻易传播。这也就意味着可能让H5N1病毒在人类之间轻易传播。关于此项研究的安全性和合适性的争论已经浮出水面。美国国家生物安全科学咨询委员会（NSABB）建议此项H5N1研究在大幅度编辑的前提下发表。NSABB特别指出，科学期刊公布该项研究是不应该包含详尽的方法学内容，以降低复制该项研究的风险和故意的不正当使用。NSABB的此项建议已经让科学界分成两派，一派支持审查制度，另一派反对审查制度。在第一份年报研究评述中，Thomas V.Inglesby,医学博士，匹兹堡大学医学中心生物安全中心首席执行官和总经理，指出改造后的可在人类之间传播H5N1病毒株的潜在后果将是振聋发聩的。如果该新近改造的H5N1病毒株逃离了实验室，和季节性流感一样广泛传播，可以危及亿万人的生命。不管该病毒株是意外或者故意逃离实验室的，变异病毒株的高传染性和致命的本质可以导致极大的灾难。此项科研工作是为了增加对H5N1的科学知识。但没有证据显示实验室中改造出的病毒株会在自然条件下发生。Inglesby博士因此提示此项研究的害处超过了其好处。如果我们要求整个人类社会为有着60%死亡率，可在人类间传播的H5N1病毒株去承担实质的，史无前例的风险，我们最好对此病毒株有一个急切的，具体的和现实的公共健康辩护说辞。Inglesby博士如是写道。他建议，如果此项研究一定要继续，应该限制病毒株的使用，就象针对天花所采取的方法。Andrew T.Pavia，医学博士，犹他大学健康科学中心儿童医院的儿童传染病部主任，是第二份年报关于此议题的研究评述的作者。Pavia博士争论到H5N1病毒也许没有有些人怀疑的那样，很容易在人类之间传播。关于H5N1变异株会被用作生物武器，Pavia博士认为这样的场景不太可能。要操控H5N1变异株作为武器，恐怖分子需要实质性的科学技术，和研究中所用到的方法的精准知识。Pavia写道有合适的安保措施，这些和将来的关于H5N1的研究应该继续进行，以此增加对流感的重要科学认识。目前，没有一个透明和周全的机制确保只向有合法需求的人们提供该项研究的细节和如何决定合法的人选。Pavia博士因为大体上同意美国国家生物安全科学咨询委员会（NSABB）所采取的方法，同时争论到在实验室创造更加危险的病原体有它自身的目的。居Pavia博士所说：我们必须有一个谨慎和平衡的方法，既做到不要太胆小以致不敢批准试验和分享重要研究，又不会因为研究稚嫩，和生物安全议题相冲突。于此同时，研究者自身已经宣布在争论仍在继续的情况下，暂停研究60天。

2012-01-30 15:31

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