Disease X, the next pandemic? Why the WHO is concerned

What is disease X that the WHO has warned about?

In recent days there has been a lot of talk about disease cause 20 times more deaths than the COVID-19 pandemic.

But what does it really consist of? Disease greater risk due to its epidemic potential and on which it is urgent to investigate to avoid a new pandemic.

“Disease It is, therefore, not a real pathology, but the possibility that a hypothetical unidentified pathogen triggers a pandemic that could be much more serious than that caused by the SARS-CoV-2 coronavirus.

Dr. Federico Arribas Monzón, member of the Spanish Society of Epidemiology (SEE), explains to WebConsultas that the aforementioned ‘Disease moment.

“It is something classic in epidemiology; When communicable diseases are studied, there has always been talk of the possible emergence of a new virus, or the modification of an existing one that is highly transmissible and has high lethality. Epidemiological surveillance systems monitor ‘de facto’ the appearance of outbreaks due to new viruses (for example, changes in influenza viruses), or viruses that exist in the animal world and are transmitted to humans with the capacity to be contagious between people. .. Therefore, it is nothing new.”

Adelaida Sarukhan, PhD in immunology and scientific writer at ISGlobal, explains to WebConsultas that “the last update of the WHO list of priority pathogens or diseases, in 2018, included disease X for the first time as a way to recognize that there are pathogens that we do not yet know and could cause a pandemic”, and adds: “we can say that the first disease human being, it began to be transmitted between people and caused a great pandemic.”

Dr. Arribas points out: “This type of news, misused, seems to want to frighten the population, it is not known for what purposes. My point of view is that we will always have this potential threat, so it is necessary to strengthen epidemiological surveillance systems to be able to detect these changes as soon as possible and establish control measures early. That is, it is necessary to know that this could happen to be prepared, but not to cause unfounded fear.”

Objective: be prepared to respond to a new pandemic

The purpose of the creation of the concept ‘disease “Including disease as priorities and for which we have developed antivirals, vaccines, etc. It helps us prepare better for the unknown and act faster. It is about defining a framework of action to accelerate our response if something new arises,” says Adelaida Sarukhan.

For his part, Dr. Richard Hatchett, executive director of the Coalition for Epidemic Preparedness Innovations (CEPI), explained in a UN blog: “The X in ‘Disease X’ represents everything we don’t know. It is a new disease, about which we will know very little when it first emerges: it may or may not be fatal, highly contagious and a threat to our way of life. We also do not know when or how it will cross the viral border and infect people. What we do know is that the next Disease X is approaching and that we have to be prepared.”

The expert also pointed out that CEPI’s claim was that it would be possible to respond to the hypothetical disease X with a new vaccine in just 100 days. “It takes just over three months to deactivate the threat of a pathogen with the potential to cause a pandemic. Coupled with improved surveillance that provides early detection and warning, and rapid and effective use of non-pharmaceutical interventions, delivery of a vaccine within 100 days would give the world a fighting chance to extinguish the existential threat of a future pandemic virus.”

“It is indeed interesting the work that is done in the field of research to be able to produce a specific vaccine or a new drug in a quick time. Many times this speed is due to the fact that research has been going on for a long time and that years of knowledge is used for a new vaccine or a new drug. For this reason, support for research is another of the measures to be carried out,” says Dr. Arribas Monzón, who adds: “At the national level, the creation of a Public Health Agency that would coordinate all these issues would be a “an important element for the control of these possible emerging diseases.”

An article published in the scientific journal European Journal of Public Health identified the following key strategies to be prepared for ‘disease X’:

• All those measures aimed at reducing the risk of contact with natural reservoirs of unknown viruses (spillover effect)
• Improve disease surveillance in humans and animals
• Rapidly detect and sequence the infectious agent
• Strengthen research programs to reduce the delay between the development and production of therapeutic options
• Accelerate the implementation of pharmaceutical and non-pharmaceutical measures
• Development of international protocols to ensure the fair and global distribution of drugs and vaccines.

Candidate pathogens to star in the next pandemic

Among the candidates to cause the next disease that we have to combat them.”

The researcher highlights that zoonotic viruses – those that live in animal reservoirs – represent one of the greatest threats to humanity because there are many that we do not know about and we increasingly invade more habitats and come into contact with bats and other animals, thus favoring the jump of these pathogens from one species to another.

Another danger, says the expert, is climate change and land use in the Arctic, where viruses hundreds of thousands of years old have been found and reactivated. “Here there is also a possible source of viruses with pandemic or, at least, epidemic potential. They call them ‘zombie’ viruses, it seems a little alarmist to me, but it is important and scientists are also warning about the possibility of the spread of one of these viruses that have remained latent for hundreds of thousands of years. Maybe nothing happens and it doesn’t even have the capacity to infect humans, but if one out of thousands has it, it can pose a risk.”

Other priority diseases highlighted by the WHO

The other eight diseases that constitute a public health priority according to the WHO are:

• COVID-19
• Crimean-Congo hemorrhagic fever
• Ebola virus disease
• Marburg virus disease
• Lassa fever
• Middle East respiratory syndrome (MERS-CoV)
• Severe acute respiratory syndrome (SARS)
• Nipah and henipaviral diseases
• Rift Valley Fever
• Zika virus infection.

“This list of priority pathogens has become a reference point for the research community on where to focus energies to manage the next threat,” said Dr Soumya Swaminathan, WHO Chief Scientist. “It is developed together with experts in the field and is the agreed direction of where we, as a global research community, need to invest energy and funds to develop tests, treatments and vaccines.”

In fact, we still do not have vaccines to prevent all infectious diseases that can cause epidemic outbreaks. Adelaida Sarukhan has highlighted that “the WHO is in the process of updating this list of pathogens, which will obviously continue to include disease , SARS, the Ebola virus…–, now they are doing a review more by viral families because this will help prepare us not only for a specific pathogen, but for an entire family of pathogens.”