'Inconvenient truths' in the pursuit of scientific knowledge and public health

摘要

In this issue of The Journal of Infectious Diseases, a group of scientists and physicians from a state public health laboratory present a discovery with important scientific, public health, and security implications, and a difficult dilemma [1, 2]. Their identification of a novel, eighth botulinum neurotoxin (BoNT) from a patient with botulism expands our understanding of Clostridium botulinum and BoNT diversity, C. botulinum evolution, and the pathogenesis of botulism, but it also reveals a significant public health vulnerability. This new toxin, BoNT/H, cannot be neutralized by any of the currently available antibotulinum antisera, which means that we have no effective treatment for this form of botulism. Until anti-BoNT/H antitoxin can be created, shown to be effective, and deployed, both the strain itself and the sequence of this toxin (with which recom-binant protein can be easily made) pose serious risks to public health because of the unusually severe, widespread harm that could result from misuse of either [3].