It sounds like a benign coordinate or reference number but make no mistake H5N1 is far from benign. It’s an influenza virus ruthlessly efficient at killing those unfortunate enough to encounter it. You can’t catch it like conventional flu; victims contract it by eating poultry infected with the bug.



But global health authorities know that viruses mutate and evolve and fear a version of the bird flu that someday can be caught atmospherically - a sneeze on the subway, a cough in a crowd.



‘Well there’s no way of saying how many humans would die. (The Spanish flu of 1918) killed 100 million human beings with a 2% kill rate - 98 per cent of people infected survived it. So jump to the age of globalisation, rapid air travel, movement of humans and imagine a 50% kill rate.’ LAURIE GARRETT Pulitzer Prize Winning Science Writer



Scientists haven’t waited for nature to contrive this version of H5N1. They’ve made it themselves. Two separate research projects – one in The Netherlands and the other in the US – engineered a version of bird flu that can be transmitted atmospherically. Rotterdam researchers mutated the virus in an experiment using ferrets and the results were devastating.



‘The respiratory tracts of the ferrets behave exactly the same way as respiratory tracts of humans. And indeed with just a handful of mutations the bird flu virus can now be transmitted between ferrets via coughing and sneezing’. RON FOUCHIER Virologist, Rotterdam.



The research has not only divided the scientific community but it’s also enraged global security agencies concerned about bio-terrorism. Can the world be sure the labs involved in this work were as secure as they should be? Should the two research projects be allowed to publish their findings, including, effectively, the recipe for the mutated virus?



‘We scientists have to communicate and we do so via publications.’ RON FOUCHIER



In this important and unmissable program, Foreign Correspondent examines the furious debate over the merits of the science, the reasons behind it and – beyond a brokered short-term moratorium on publishing the data - whether or not the projects should be able to go to print.



‘So when you go to the next step - bioterrorism - it could be a homicidal jerk who wants to kill his wife or it could be an organisation that believes it’s time to bring on the apocalypse because that's their religious frame of reference … we now have that tool kit at hand and this experiment really pushes everything and argues for better policies than anybody has on the table.’ LAURIE GARRETT



Hong Kong harbour/skyline




FOWLER: Hong Kong, population seven million. One of the most densely populated places on earth. Here life is cheek-by-jowl, shoulder to shoulder on the streets and in the subway. So when contagions appear, they can spread like wildfire.


Airport arrivals/departures board

And in this busy international hub a stone’s throw from the billion strong mainland and a plane trip to the rest of the world,


Helicopters over harbour

they take military style precautions.





Plane landing

LAURIE GARRETT: “For a long time we’ve been watching this horrible virus H5N1 -- a.k.a. bird flu -- circulating primarily in Asia through the Middle East to North Africa and worrying because


Garrett. Super:
Laurie Garrett
Journalist & author

the mortality rate has been enormous. I mean there’s nothing that comes close except Ebola and rabies”.


Inside hospital, scrubbing up




FOWLER: Hong Kong found itself in the thick of a deadly crisis when SARS - Severe Acute Respiratory Syndrome - roared over the border from mainland China ten years ago. An epidemic had turned pandemic, thousands were infected and hundreds died.


Ambulance to hospital/Infectious disease centre





DR S.T. LAI: “Because of the experience the government in Hong Kong had decided to build a centre in which we can place the highly infectious cases, be it SARS or other diseases, inside.


Dr Lai. Super:
Dr S.T. Lai
Princess Margaret Hospital, Hong Kong

The cases were treated by a special team of specialists and nurses, hoping that the disease would be contained, rather than treat it in the community”.


Suited up medical staff in hospital

FOWLER: It’s a good thing Hong Kong built this super secure facility in response to the SARS outbreak because another viral killer was about to break loose again.


Medical staff with patient

It was 2008 and the bug was bird flu, specifically H5N1.

DR S.T. LAI: “Patients, they told me that when they got the disease they feel very frightened and when they were put into the isolation rooms, they feel


Dr Lai

very lonely and also they are afraid they may die at any moment”.


Dr Lai and colleague in hospital corridor

FOWLER: Infectious diseases specialist Dr Lai and his team stared down that bird flu outbreak but they remain on an emergency footing, running drills and staying vigilant and prepared for the next inevitable round.


Dr Lai

DR S.T. LAI: “I think this is a highly infectious and also a highly fatal disease and if you get it, the mortality rate is very high. Say if you’re treating ten patients, six may die. So this is a big killer”.





Chickens/Chicken slaughter/cooking

FOWLER: Bird flu doesn’t behave like normal flu. Victims don’t contract it from others but by contact with infected poultry. Controversial research on the other side of the world means the burning question gripping medical, scientific – even security experts right now – is not will the virus evolve into one transmitted from human to human, but when and how.



LAURIE GARRETT: “What happens if this becomes a human to human transmissible microbe?



Up until now, there’s only spotty evidence that any human ever actually, you know, cough cough, gave it to and infected another human


Street shots

and so it seemed to lack some essential genetic material that would make it a typical influenza, you know,



rapidly spreading around the world the way the swine flu did in 2009.



Well, what would it take? You know what’s the missing genetic piece?”





Exterior. Erasmus Medical Centre

FOWLER: In the heart of Rotterdam, scientists at the Erasmus Medical Centre were trying to crack that exact question. They were at work on an extraordinary experiment --



Ferret sequence

making ferrets sick with the H5N1 flu virus.

DR RON FOUCHIER: “And while ferrets are not similar to humans in many aspects -- of course they look quite different --


Dr Fouchier. Super:
Dr Ron Fouchier
Erasmus Medical Centre, Rotterdam

but the respiratory tract of the ferrets behaves exactly the same way as the respiratory tract of the human. So viruses, influenza viruses replicate in the same cells, they cause the same type of disease and the transmission patterns are the same”.


Stylised lab research sequence




FOWLER: The team lead by respected virologist Ron Fouchier was trying to discover if ferrets could pass on the H5N1 virus to each other, simply by breathing the same air.

DR RON FOUCHIER: “What we have done is taken an ordinary bird flu virus,


Dr Fouchier

mutate it based on the facts from the literature that we already know, then passage it in ferrets to see if we can make it go airborne”.


Stylised lab research sequence

FOWLER: If the ferrets pass the disease on to others, the theory was humans could, too. And if scientists could manipulate the virus then they were only doing what nature could conceivably do itself.



DR RON FOUCHIER: “And indeed, with just a handful of mutations the bird flu virus can now be transmitted between ferrets



Dr Fouchier

via coughing and sneezing, so the way viruses are usually transmitted between humans. And so we show for the first time that a bird flu virus can gain this capacity and we also show that it can happen very, very easily with just a handful of mutations”.


Stylised ferret sequence




LAURIE GARRETT: “Ron Fouchier in Rotterdam answered the question after ten passages through the ferret population. He walks in and sees 75% of his ferrets are dead and it had been cough-airborne transmissible between the cages. So he’d made it. He’d made the super flu.


Garrett. Super:
Laurie Garrett
Journalist & author

And the super flu seems to have roughly 75% kill rate, is highly transmissible, virtually all the animals got infected and transmissible the same way that regular flu is. That’s scary stuff.


Photos. Spanish flu epidemic

FOWLER: Scary doesn’t really do it justice. The Rotterdam team had created a super bug that potentially could make the Spanish flu look mild.


Wisconsin university

And incredibly this wasn’t the only flu experiment funded by the US Government. In the American state of Wisconsin,


Photos. Kawaoka/Microbes

Yoshihiro Kawaoka led a team applying different techniques that achieved the same result. They’d hatched a super virus.



LAURIE GARRETT: “Combined, what they show us, is frightening”.


Time-lapse. Laurie Garrett on street

FOWLER: Laurie Garrett has become a front line critic of the H5N1 projects. The science journalist and author won a Pulitzer prize for her coverage of the African Ebola virus. The bird flu mutant has her very worried indeed.



LAURIE GARRETT: “Well, of course there’s no way to say how many human beings would die if such a virus got out”.


Film excerpt. Super:
Warner Bros. Pictures

FOWLER: For Garrett, there was a strange confluence of fact and fiction. The bird flu research was emerging not long after she emerged from an advisory role on this, the film “Contagion”. It’s Hollywood’s amplified version of a super bug scenario. A bug virulent enough to destroy vast populations is stalking the streets of Hong Kong, passed on all too easily like the mutated H5N1 virus. For Garrett, suddenly the fiction was potentially all too real.



LAURIE GARRETT: “I would simply remind you that in 1918 in 12 months time in the absence of commercial air travel or globalisation, influenza killed a hundred million human beings and only had a 2% kill rate. Meaning 98% of the people who got infected, survived it. So if you now jump to the age of globalisation, rapid air travel, movement of humans, their animals everything all over the planet, we are all one giant organism now and imagine a 50% kill rate, you know, you can do the math”.


Archival. Spanish flu





FOWLER: When epidemiologists go looking for stark examples of the devastating impact of viruses on human populations they head without pause to 1918. The precise death toll is unclear but tens of millions died in the Spanish flu pandemic. Certainly medicine is far more sophisticated now and smarter too, but the same can be said of viruses, particularly when they’ve been purpose built by science itself.



DR VINCENT RACANIELLO: “I think that much of the rhetoric is alarmist and overblown”.


Dr Racaniello in lab

FOWLER: Dr Vincent Racaniello is a world renowned virologist, unashamedly on the side of the bird flu engineers.



DR VINCENT RACANIELLO: “1918 influenza was a very unusual outbreak, it was probably exacerbated by the massive troop movements and other issues. Nothing since has been as fatal as far as influenza goes,


Dr Racaniello. Super:
Dr Vincent Racaniello
Columbia University

but as you know influenza travels rapidly among people and even before air travel, the virus was quite good at travelling around the globe very quickly and so that’s a quality of the virus that scares people, because if you couple that with a lethal strain, then it could be potentially bad, but we shouldn’t assume that the H5N1 would be as lethal as 1918”.


Rotterdam ambulance



Exterior. Erasmus MC

FOWLER: Back in the 21st century, concern fixed on the security of the labs involved in this research. Having hatched the super virus, can they contain it?



DR RON FOUCHIER: “It’s a very high secure, high bio-safety laboratory.


Dr Fouchier. Super:
Dr Ron Fouchier
Erasmus Medical Centre, Rotterdam

And over the last 15 years, where dozens of labs have worked with H5N1 virus, there has not been a single case of accidental exposure of laboratory workers or the environment.



I would say that these laboratory facilities are sufficiently safe and secure”.



DR VINCENT RACANIELLO: “We’ve had dangerous viruses under lock and key for years and


Dr Racaniello

they generally don’t get out. I think it’s fine, especially since I don’t think this is a particularly dangerous virus for humans. I don’t think it’s a problem at all”.



LAURIE GARRETT: “My concern is not February 2012 or March 2012,


Garrett. Super:
Laurie Garrett
Journalist & author

or perhaps even February 2013. My concern is when that virus has been sitting there in the freezer for a while, and everybody sort of, you know, has moved on to other things in their lives, other experimental efforts and so on, and things get lax -- and this happens all the time”.


Dr Osterholm. Super:
Dr Michael Osterholm
US Biosecurity advisor

DR MICHAEL OSTERHOLM: “If influenza got out today it’s gone, it’s absolutely gone. We don’t get a second chance to stop it, and so what we are saying here today is it’s not that we don’t trust scientists, but lab accidents happen.


Stylised bio-security sequence

We know that all the time”.




FOWLER: But concerns about the security of the research facilities were nothing compared to the storm that erupted when the Wisconsin and Rotterdam projects declared their intentions to publish their work in peer reviewed journals, Science and Nature. It would include a breakdown of precisely how they did it.


Dr Fouchier

DR RON FOUCHIER: “We scientists have to communicate and we do so via publications”.


Stylised ferrets

DR VINCENT RACANIELLO: “I think the work on H5N1 transmissibility in ferrets is excellent.


Dr Racaniello

They were good experiments, they were well designed and they should be continued as well because they provide a lot of information for understanding this virus”.


Stylised US, Dr Osterholm

FOWLER: The intention to publish set off alarms in the US Government. It took its lead from a key group of advisers, including renowned anti-smallpox pioneer, Dr Michael Osterholm.



DR MICHAEL OSTERHOLM: “We recognised right away that we were walking into a very, very controversial area. In this case,.



Dr Osterholm

if we published the full un-redacted version of their research with all the sequences included, then modern molecular genetics starts to kick in. We do know that labs that couldn’t otherwise have done the work easily, if at all, now within a month for several thousand dollars could actually create these same viruses even if it were not for ill intent, just to see what they could do with them”.


Columbia University grounds

FOWLER: Osterholm and his colleagues on the National Science Advisory Board for Bio-Security were unambiguous. Publishing the research presented intolerable risks. It should not go to print.



LAURIE GARRETT: What’s happened at Science and Nature has never happened before. We are in completely new territory here.



When our American National Science Advisory Board on Bio-Security reviewed what had been done in these experiments and what the potential risks and hazards were, they asked - they do not have the power to command - they asked the two relevant publications to not run the materials and methods, the sort of ‘how to’ section, of the papers that traditionally appears in all biology published publications.



Of course, the authors disputed that and said, you know, ‘We have to publish this. There’s no validity to science if you don’t say how you did it’”.



DR VINCENT RACANIELLO: “I think it was wrong for them to decide that it shouldn’t be published because I think the scientific benefits outweigh the risks by far.


Dr Racaniello

I think having the information published allows the field to go forward. If we think this virus is dangerous, it makes no sense to restrict the distribution of information because the way science works, you publish your paper, other scientists get the information and then they go forward with those data. And now we’re preventing that from happening”.


Stylised poultry bio-security sequence




DR RON FOUCHIER: “We have to be prepared for such viruses to emerge in the wild. If we would detect these viruses out in the field, then we could go out to outbreak areas and try to eradicate the virus and prevent a pandemic from happening.


Dr Fouchier

If that would fail, then we would still be in a good position to, ahead of that pandemic, evaluate our vaccines and antiviral drugs and therefore gain months of time if a pandemic would hit and therefore we would be able to handle it better”.


Tokyo streets




FOWLER: As a harsh winter gripped much of the Northern Hemisphere and conventional flu marched out and claimed its victims, particularly in Japan, debate raged about the rights of science to freely publish its work and whether or not anti terror agencies were entitled to make the call to censor that material.



DR MICHAEL OSTERHOLM: “What we really worry about more I think is the... what I’d call the lone offender.


Dr Osterholm. Super:
Dr Michael Osterholm
US Biosecurity advisor

Someone who is just angry who wants to do it. A Ted Kaczynski who was nuts but who made a hell of a bomb, type of person who has the science background”.


Building exterior




FOWLER: Eventually, the two journals accepted a moratorium, to hold off publication for two months. Just weeks into that compromise another deal; the material would be published later this year but precisely when and in what form is not clear.


Stylised lab sequence

DR VINCENT RACANIELLO: “I think the problem is that we have a new climate post 9/11 and post anthrax. People are worried about bio-terrorism.


Dr Racaniello

The extent to which that limits your ability to do science is problematic because I think the likelihood of people developing bio-weapons is probably remote and you have to balance that against research going forward that can improve human health. So I don’t think we should worry about imagined threats to the extent that they restrict our ability to do research that makes everyone’s health better”.



DR MICHAEL OSTERHOLM: “Now, we never for once saw ourselves as the court of last resort and in fact we saw ourselves as really the first review and if this had to entail a global, worldwide discussion of live science community.



Dr Osterholm

And so you might look at us as really just putting the brakes on things, to say wait a minute, take a pause, we can’t go back and redo it. We can’t un-ring a bell. But we can, after careful deliberation and decision, then go ahead and do it, and I think that’s the message that we have tried very hard to get out loud and clear and we will continue to do that”.


Indonesia – Poultry flu shots




FOWLER: In Indonesia and around Asia’s bird flu hot zone, the current form of H5N1 continues to claim victims. Despite extensive culling programs, poultry still plays host to the killer virus and there are no campaigns sophisticated and pervasive enough to warn potential victims of the risks in their daily meal, let alone the perils of an airborne version that may emerge one day soon.



DR MICHAEL OSTERHOLM: “So what we do know is that there will be more influenza pandemics – they’re like earthquakes, hurricanes and tsunamis, they occur.


Dr Osterholm

We don’t know what the next strain will be of influenza virus that will cause it and if it is H5N1, whether it be because of a mother nature made event or because of a man made event by intent or by even accidental escape out of a laboratory, the outcomes are all about the same”.


Hong Kong Infectious Disease Centre





FOWLER: Back in Hong Kong’s Infectious Disease Centre the team know it’s only a matter of time before the emergency drills make way for another outbreak. But will it be the H5N1 they already know or will it be a variant?


Dr Lai. Super:
Dr S.T. Lai
Princess Margaret Hospital, Hong Kong

DR S.T. LAI: “Should there be a change in the virus, I am pessimistic that we may not be able to deal with the pandemic outbreak because we don’t have enough drugs, we don’t have enough expertise and we don’t have enough facilities. So I think if the virus changes there will be a disaster.


Hong Kong ambulances/Hong Kong streets

The toll of death will be in terms of millions and millions, just like the Spanish flu. So we may repeat the same history if we are not prepared”.



FOWLER: And as Dr Lai and his team prepare, the debate about science and security rages on.


Dr Racaniello

DR VINCENT RACANIELLO: “I’ve been working in science for over 30 years and all the scientists I know are responsible individuals who do work under the appropriate conditions and they’re interested in advancing human health.


Crowded trains, Indonesia

I sure believe that scientists can regulate themselves. I know many other people don’t believe that, we understand I think best what kind of potential the experiments have and if anything, we should have a strong say in the matter of any regulation that takes place”.





go to the next step and ask me about bio-terrorism, about let’s just say malevolent individuals, for whatever purpose, it could be a homicidal jerk that just wants to kill his wife, or it could be, you know, an organisation that believes it’s time to bring on the apocalypse because that’s their religious frame of reference, right?


Stylised bio-security sequence




LAURIE GARRETT:  We now have that tool kit at hand and this experiment really pushes everything and argues



for a much broader and a much more carefully thought out set of policies than anybody currently has on the table”.


Visual recap montage













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