{"id":41364,"date":"2024-09-27T21:35:53","date_gmt":"2024-09-27T17:35:53","guid":{"rendered":"http:\/\/www.mauritiustimes.com\/mt\/?p=41364"},"modified":"2024-09-27T21:35:53","modified_gmt":"2024-09-27T17:35:53","slug":"what-pathogen-might-spark-the-next-pandemic-how-scientists-are-preparing-for-disease-x","status":"publish","type":"post","link":"https:\/\/www.mauritiustimes.com\/mt\/what-pathogen-might-spark-the-next-pandemic-how-scientists-are-preparing-for-disease-x\/","title":{"rendered":"What pathogen might spark the next pandemic? How scientists are preparing for \u2018disease X\u2019"},"content":{"rendered":"

\"\"<\/u><\/span><\/p>\n

 <\/p>\n

Public Health<\/u><\/span><\/p>\n

Before the Covid pandemic, the World Health Organization (WHO) had made a list of priority infectious diseases. These were felt to pose a threat to international public health, but where research was still needed to improve their surveillance and diagnosis. In 2018, \u201cdisease X\u201d was included, which signified that a pathogen previously not on our radar could cause a pandemic.<\/span><\/p>\n

\"\"<\/span><\/p>\n

While it\u2019s one thing to acknowledge the limits to our knowledge of the microbial soup we live in, more recent attention has focused on how we might systematically approach future pandemic risks.<\/span><\/p>\n

Former US Secretary of Defense Donald Rumsfeld famously talked about \u201cknown knowns\u201d (things we know we know), \u201cknown unknowns\u201d (things we know we don\u2019t know), and \u201cunknown unknowns\u201d (the things we don\u2019t know we don\u2019t know).<\/span><\/p>\n

Although this may have been controversial in its original context of weapons of mass destruction, it provides a way to think about how we might approach future pandemic threats.<\/span><\/p>\n

Influenza: a \u2018known known\u2019<\/strong><\/span><\/p>\n

Influenza is largely a known entity; we essentially have a minor pandemic every winter with small changes in the virus each year. But more major changes can also occur, resulting in spread through populations with little pre-existing immunity. We saw this most recently in 2009 with the swine flu pandemic.<\/span><\/p>\n

However, there\u2019s a lot we don\u2019t understand about what drives influenza mutations, how these interact with population-level immunity, and how best to make predictions about transmission, severity and impact each year.<\/span><\/p>\n

The current H5N1 subtype of avian influenza (\u201cbird flu\u201d) has spread widely around the world. It has led to the deaths of many millions of birds and spread to several mammalian species including cows in the United States and marine mammals in South America.<\/span><\/p>\n

Human cases have been reported in people who have had close contact with infected animals, but fortunately there\u2019s currently no sustained spread between people.<\/span><\/p>\n

While detecting influenza in animals is a huge task in a large country such as Australia, there are systems in place to detect and respond to bird flu in wildlife and production animals.<\/span><\/p>\n

It\u2019s inevitable there will be more influenza pandemics in the future. But it isn\u2019t always the one we are worried about.<\/span><\/p>\n

Attention had been focused on avian influenza since 1997, when an outbreak in birds in Hong Kong caused severe disease in humans. But the subsequent pandemic in 2009 originated in pigs in central Mexico.<\/span><\/p>\n

Coronaviruses: an \u2018unknown known\u2019<\/span><\/p>\n

Although Rumsfeld didn\u2019t talk about \u201cunknown knowns\u201d, coronaviruses would be appropriate for this category. We knew more about coronaviruses than most people might have thought before the COVID pandemic.<\/span><\/p>\n

We\u2019d had experience with severe acute respiratory syndrome (SARS) and Middle Eastern respiratory syndrome (MERS) causing large outbreaks. Both are caused by viruses closely related to SARS-CoV-2, the coronavirus that causes COVID. While these might have faded from public consciousness before COVID, coronaviruses were listed in the 2015 WHO list of diseases with pandemic potential.<\/span><\/p>\n

Previous research into the earlier coronaviruses proved vital in allowing Covid vaccines to be developed rapidly. For example, the Oxford group\u2019s initial work on a MERS vaccine was key to the development of AstraZeneca\u2019s COVID vaccine.<\/span><\/p>\n

Similarly, previous research into the structure of the spike protein \u2013 a protein on the surface of coronaviruses that allows it to attach to our cells \u2013 was helpful in developing mRNA vaccines for Covid.<\/span><\/p>\n

It would seem likely there will be further coronavirus pandemics in the future. And even if they don\u2019t occur at the scale of Covid, the impacts can be significant. For example, when MERS spread to South Korea in 2015, it only caused 186 cases over two months, but the cost of controlling it was estimated at US$8 billion (A$11.6 billion).<\/span><\/p>\n

The 25 viral families: an approach to \u2018known unknowns\u2019<\/strong><\/span><\/p>\n

Attention has now turned to the known unknowns. There are about 120 viruses from 25 families that are known to cause human disease. Members of each viral family share common properties and our immune systems respond to them in similar ways.<\/span><\/p>\n

An example is the flavivirus family, of which the best-known members are yellow fever virus and dengue fever virus. This family also includes several other important viruses, such as Zika virus (which can cause birth defects when pregnant women are infected) and West Nile virus (which causes encephalitis, or inflammation of the brain).<\/span><\/p>\n

The WHO\u2019s blueprint for epidemics aims to consider threats from different classes of viruses and bacteria. It looks at individual pathogens as examples from each category to expand our understanding systematically.<\/span><\/p>\n

The US National Institute of Allergy and Infectious Diseases has taken this a step further, preparing vaccines and therapies for a list of prototype pathogens from key virus families. The goal is to be able to adapt this knowledge to new vaccines and treatments if a pandemic were to arise from a closely related virus.<\/span><\/p>\n

Pathogen X, the \u2018unknown unknown\u2019<\/strong><\/span><\/p>\n

There are also the unknown unknowns, or \u201cdisease X\u201d \u2013 an unknown pathogen with the potential to trigger a severe global epidemic. To prepare for this, we need to adopt new forms of surveillance specifically looking at where new pathogens could emerge.<\/span><\/p>\n

In recent years, there\u2019s been an increasing recognition that we need to take a broader view of health beyond only thinking about human health, but also animals and the environment. This concept is known as \u201cOne Health\u201d and considers issues such as climate change, intensive agricultural practices, trade in exotic animals, increased human encroachment into wildlife habitats, changing international travel, and urbanisation.<\/span><\/p>\n

This has implications not only for where to look for new infectious diseases, but also how we can reduce the risk of \u201cspillover\u201d from animals to humans. This might include targeted testing of animals and people who work closely with animals. Currently, testing is mainly directed towards known viruses, but new technologies can look for as yet unknown viruses in patients with symptoms consistent with new infections.<\/span><\/p>\n

We live in a vast world of potential microbiological threats. While influenza and coronaviruses have a track record of causing past pandemics, a longer list of new pathogens could still cause outbreaks with significant consequences.<\/span><\/p>\n

Continued surveillance for new pathogens, improving our understanding of important virus families, and developing policies to reduce the risk of spillover will all be important for reducing the risk of future pandemics.<\/span><\/p>\n

Allen Cheng<\/span>
\n<\/strong>Professor of Infectious Diseases
\nMonash University<\/span><\/p>\n

\n

Mauritius Times ePaper Friday 27 September 2024<\/strong><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

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