The recent controversial studies of man-made avian flu viruses caused a media storm, and brought new concerns to the potential of an avian influenza H5N1 virus pandemic, which has been pending since 19971,2. Although the estimated mortality rate of avian influenza A H5N1 virus infection in humans could be as high as 60%, the World Health Organization (WHO) phase of pandemic alert is currently set at 3, due to that there has not been human-to-human or community-level transmission (http://www.who.int/influenza/preparedness/pandemic/h5n1phase/en/index.html). However, the newly created H5N1 virus strains, which are genetically altered, are transmissible among ferrets, and thus may trigger a real pandemic that could potentially result in millions of deaths according to Science Insider3. While it is arguably a bit too late to debate whether regulations or mandatory reviews should be applied to these dual-use studies, in the matter of fact, these viruses that are probably among the most dangerous infectious agents known already exist. Therefore, a top priority at present is to find effective prophylactic or therapeutic agents that would help to control a pandemic of avian influenza A H5N1 viruses.

Previous reports have demonstrated that the high mortality in humans infected with avian influenza A H5N1 is partly due to acute lung injury or the resulting severe condition, acute respiratory distress syndrome (ARDS)4,5. There are few treatment choices for ARDS, aside from mechanical supporting equipment and empirical treatments. The use of cortisones is controversial.

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