June 4, 2004

Tony Fauci: Sequencing microbes "transforms" fight against infectious disease

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From left to right: Robert M. Johnson, M.D., associate clinical professor of Medicine; John S. Johnson, M.D., professor of Medicine; and Anthony Fauci, M.D., director of the National Institute for Allergy and Infectious Diseases.

Tony Fauci: Sequencing microbes "transforms" fight against infectious disease

The ability to “read” the genetic code of microbes may be more important for public health than the much-touted sequencing of the human genome, Anthony Fauci, M.D., said last week at Vanderbilt University Medical Center.

“We now can sequence microbes in less than a day,” said Fauci, director of the National Institute of Allergy and Infectious Diseases.

“The technology of being able to do it in such a brief period of time in my mind is probably the major transforming event in microbiology and infectious diseases.”

Using sequencing technology, scientists can determine the exact order of chemical building blocks that make up an organism’s DNA, or genetic material.

Such technology permitted rapid identification of the coronavirus responsible for last year’s outbreak of Severe Acute Respiratory Syndrome (SARS), Fauci said.

Sequencing provides the information necessary to develop new anti-viral or antibiotic drugs, as well as vaccines to meet the challenges of emerging and re-emerging infections ranging from West Nile virus to influenza, he added.

Fauci delivered the Paul Michael Lecture in Medicine last Thursday, hours before President George W. Bush’s visit to the Medical Center.

John S. Johnson, M.D., professor of Medicine and vice chair for clinical affairs at St. Thomas Hospital, introduced Fauci, who trained in Johnson’s lab at the National Institutes of Health in the late 1960s. “He has extraordinary intellect, boundless energy and a nose for the right questions,” Johnson said of his former student.

Today Fauci leads much of the government’s fight against AIDS, as well as efforts to develop countermeasures against a bioterrorist attack. What worries him more than anything else, he said, is “the ever-present threat of a pandemic of influenza.”

Last winter in Thailand and Vietnam, more than 30 people were sickened by a particularly virulent strain of flu that came from chickens, and three quarters of them died.

If, through mutation, this virus becomes capable of being spread from person to person, “we have the possibility of the unthinkable, which is something like we had in 1918-1919,” Fauci said.

The worldwide flu pandemic killed more than 20 million people, including 500,000 in the United States.

Fortunately, scientists have developed a technique, called reverse genetics, which can speed up the annual process of flu vaccine production from months to a matter of weeks. “This is going to transform our ability to respond to influenza,” Fauci said.

Sequencing technologies also are advancing the battle against ancient diseases such as malaria, which kills two million people worldwide each year, and emerging infections like the mosquito-transmitted West Nile virus, which appeared in the United States in 1999 and was responsible for 233 deaths last year.

West Nile virus is related to the viruses that cause yellow fever and dengue. By attaching relevant genes from the West Nile virus onto the “backbone” of existing yellow fever and dengue vaccines, scientists have been able to develop a West Nile vaccine, Fauci said. It currently is undergoing safety tests in humans.

“We’ve been able to clip off literally several years of vaccine development,” he said.

Fauci attributed much of the recent progress to a substantial investment in biodefense research.

While the federal program is designed to develop countermeasures against potential biological weapons such as anthrax and smallpox, it also encourages basic infectious disease research.

As a result, he said, the scientific community today is better-equipped to meet the challenge of microbes that are constantly evolving — “the challenge that will be with us forever.”