MRC Scientists involved in a recent H5N1 Debate

MRC Centre scientists question interpretation of findings in recent meta-analysis of H5N1 serologic studies, claiming that we are “missing millions” of H5N1 infections

A recent debate over whether to publish two reports of laboratory-generated transmissible H5N1 strains – one from the Yoshihiro Kawaoka’s research team at the University of Wisconsin-Madison, USA and the other from Ron Fouchier’s research team at Erasmus University Rotterdam, the Netherlands – highlights the importance of better understanding the true incidence in humans of the highly pathogenic H5N1 virus circulating in wild and domestic avian populations.

In 2011, a review of H5N1 seroepidemiologic studies, led by Centre Scientist, Maria Van Kerkhove with colleagues from the World Health Organization, the Food and Agriculture Organization of the United Nations and the US Centres for Disease Control and Prevention and concluded that infection with H5N1 in humans is rare, despite frequent and risky practices with poultry in H5N1 endemic countries. 

A recently published meta-analysis in Science, concluded differently.  Centre scientists Maria Van Kerhove, Steven Riley and Neil Ferguson argue that this represents an incautious over-interpretation of limited and uncertain data. Although the true case fatality rate (CFR) of H5N1 will very likely be lower than the 60% found for reported lab-confirmed cases, there is little evidence of "missing millions” of infections.