title: Mammalian-transmissible H5N1 influenza: facts and perspective.
abstract: Two recently submitted (but as yet unpublished) studies describe success in creating mutant isolates of H5N1 influenza A virus that can be transmitted via the respiratory route between ferrets; concern has been raised regarding human-to-human transmissibility of these or similar laboratory-generated influenza viruses. Furthermore, the potential release of methods used in these studies has engendered a great deal of controversy around publishing potential dual-use data and also has served as a catalyst for debates around the true case-fatality rate of H5N1 influenza and the capability of influenza vaccines and antivirals to impact any future unintentional or intentional release of H5N1 virus. In this report, we review available seroepidemiology data for H5N1 infection and discuss how case-finding strategies may influence the overall case-fatality rate reported by the WHO. We also provide information supporting the position that if an H5N1 influenza pandemic occurred, available medical countermeasures would have limited impact on the associated morbidity and mortality.
authors.affiliation: Center for Infectious Disease Research and Policy, University of Minnesota, Minneapolis, Minnesota, USA. mto@umn.edu
authors.forename: Michael T
authors.initials: MT
authors.lastname: Osterholm
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Kelley
mesh_terms: D000818:Animals; D035843:Biomedical Research / Q000379:methods; D003264:Containment of Biohazards / Q000379:methods*; D005289:Ferrets; D006801:Humans; D053124:Influenza A Virus, H5N1 Subtype / Q000235:genetics* / Q000472:pathogenicity*; D007251:Influenza, Human / Q000517:prevention & control* / Q000821:virology*; D009026:Mortality; D009976:Orthomyxoviridae Infections / Q000635:transmission* / Q000821:virology; D058873:Pandemics / Q000517:prevention & control; D014944:World Health Organization; D015047:Zoonoses / Q000635:transmission