Disease X: A hidden but inevitable creeping danger (2024)

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Acknowledgments References FAQs

To the Editor—An old adage says, “Prevention is better than cure.” Nothing exemplifies this idea better than “Disease X.” According to the World Health Organization (WHO), “Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease.”1

Richard Hatchett, chief executive officer (CEO) of the Coalition for Epidemic Preparedness Innovations (CEPI), said about Disease X, “It might sound like science fiction, but Disease X is something we must prepare for.”2 In a list of diseases that the WHO considers high priority in terms of research and development, Disease X occupies a spot among diseases such as Ebola, Zika, and coronavirus disease 2019 (COVID-19).1 Unexpected outbreaks of infectious disease (Disease X) have repeatedly rocked the medical confidence and have taken the medical world by surprise.3

Some experts have even commented that COVID-19, caused by severe acute respiratory coronavirus virus 2 (SARS-CoV-2), met the standards to be considered the first Disease X,4 while some authors have called Zika a Disease X.5 However, one unfortunate possibility is that COVID-19 and other recent pandemics might have been milder versions of what will eventually be the most prominent Disease X.

Disease X is supposed to be caused by a “pathogen X.” Such a pathogen is expected to be a zoonosis, most likely an RNA virus, emerging from an area where the right mix of risk factors highly promotes the risk for sustained transmission.6

The WHO has been criticized for underreacting on pandemics such as the 2014 Ebola pandemic,7 and as an organization with limited funding and weak political power, the WHO usually fails when it comes to timely and strong acts to reduce the spread of transmissible diseases.8

A study that aimed at figuring out where the responsibility lies for the 2014 Ebola outbreak also concluded that while the WHO might have been partly to blame, it’s also the lack of cooperation from governments and delayed funding aggravates the situation.7

Scientists have also commented that although the COVID-19 pandemic has had a significant impact on the world, as soon as it disappears into the background, healthcare systems will remain the same. Politicians might use the weak recovering economy due to the pandemic as a reason to delay funding for epidemic preparation, as a result failing to produce timely effective measures.8

Similarly, while emerging zoonotic pathogens are a threat that needs to be monitored, the possibility of an engineered pandemic pathogen also cannot be ignored.9 The release of such pathogens, either through laboratory accidents or as an act of bioterrorism, might lead to a disastrous Disease X as well and has been remarked as a global catastrophic risk.10

There is a dire need to seriously fund the surveillance of, research into, and treatment of emerging potential pandemic agents that could cause Disease X.8 Despite the grim situation, steps can be taken to stop Disease X and to reduce the spread and damage of Disease X by properly and preemptively preparing for it. (1) We need to develop international guidelines to control bioterrorism. Bioterrorism attacks could also result in an epidemic, for example, if Ebola or Lassa viruses were used as biological agents. (2) Advice of the academics should be sought in a timely way without any political involvement. (3) Immediate and appropriate travel restrictions and airport screening will need to be implemented to contain the spread of pathogen X across borders. (4) The world’s scientists, clinicians, and infectious disease experts must act collaboratively to investigate, control, and eliminate the disease in a timely way. (5) Widespread testing and aggressive contact tracing can effectively contain the outbreak. (6) Timely investments can be made to accelerate the development, availability, and approval of medical countermeasures (like diagnostics, vaccines, and clinical trials) required before and during the pandemic. (7) Active surveillance of virus laboratories is needed to avoid a potential leak of a new virus.

A One Health approach has also been proposed that provides a complete way to address the underlying issues for the spread of Disease X: bridging institutional gaps, defining priority risk areas and pathogens, and emphasizing supposed risk factors for subsequent events involving emerging and re-emerging infectious disease pathogens.11 The COVID-19 pandemic was not the first to wreak havoc on the world and it will not be the last. Thus, we need to prepare for the next outbreak as soon as possible.

Acknowledgments

References

1. Prioritizing diseases for research and development in emergency contexts. World Health Organization website. https://www.who.int/activities/prioritizing-diseases-for-research-and-development-in-emergency-contexts. Accessed May 30, 2021.

2. Disease X: science fiction or a very real and frightening threat? The Telegraph website. https://www.telegraph.co.uk/global-health/science-and-disease/must-work-together-prevent-disease-x/. Accessed June 1, 2021.

3. Honigsbaum M.Disease X and other unknowns. Lancet 2019;393:1496–1497. [PMC free article] [PubMed] [Google Scholar]

4. Jiang S, Shi ZL.The first Disease X is caused by a highly transmissible acute respiratory syndrome coronavirus. Virol Sin 2020;35:263–265. [PMC free article] [PubMed] [Google Scholar]

5. Barrett AD.Developing Zika vaccines: the lessons for Disease X. Genome Med 2018;10:47. [PMC free article] [PubMed] [Google Scholar]

6. Simpson S, Kaufmann MC, Glozman V, Chakrabarti A.Disease X: accelerating the development of medical countermeasures for the next pandemic. Lancet Infect Dis 2020;20(5):e108–e115. [PMC free article] [PubMed] [Google Scholar]

7. Kamradt-Scott A.WHO’s to blame? The World Health Organization and the 2014 Ebola outbreak in West Africa. Third World Qtrly 2016;37:401–418. [Google Scholar]

8. Iserson KV.The next pandemic: prepare for “Disease X.” West J Emergency Med 2020;21:756. [PMC free article] [PubMed] [Google Scholar]

9. Armitage R, Nellums LB.Disease X: availability bias, biotechnology, and seeing beyond zoonotic risk. Public Health 2021;190:e25. [PMC free article] [PubMed] [Google Scholar]

10. Bostrom N, Cirkovic MM, editors. Global Catastrophic Risks. Cambridge, UK: Oxford University Press; 2011. [Google Scholar]

11. Chatterjee P, Nair P, Chersich M, et al. One Health,“Disease X,” and the challenge of “unknown” unknowns. Indian J Med Res 2021;153:264. [PMC free article] [PubMed] [Google Scholar]

Disease X: A hidden but inevitable creeping danger (2024)

FAQs

Should I be worried about Disease X? ›

Disease X itself is hypothetical: it does not exist. But the concept of Disease X describes a very real and growing threat to human health – and one the world must prepare better to respond to.

What is the new virus that is worse than COVID? ›

Scientists say the most likely culprit for Disease X would be a respiratory virus, possibly one already circulating in animals that hasn't yet made the jump to humans. Without preparedness, the WHO warned, a pandemic from Disease X could cause much more damage than COVID, which has killed more than 7 million worldwide.

What are five diseases caused by viruses? ›

Viruses are responsible for causing many diseases, including:
  • Common cold.
  • Influenza.
  • Measles.
  • Chickenpox and shingles.
  • Coronavirus disease 2019, also called COVID-19.
Mar 5, 2024

What is the epidemic answer? ›

An epidemic is a sudden disease outbreak that affects a large number of people in a particular region, community, or population. In an epidemic, the number of people affected by the disease is larger than what is normally expected.

What new virus is going around 2024? ›

First case of A(H1N2)v virus in the US in 2024

Variant influenza A virus infections are novel influenza A virus infections. A novel influenza A virus is an influenza A virus that is different from seasonal influenza A viruses spreading among people.

What is the new virus in China 2024? ›

On 27 January 2024, the National Health Commission of the Peoples Republic of China notified WHO of one confirmed case of human coinfection with influenza A(H10N5) virus and seasonal influenza A(H3N2) virus. This is the first case of human infection with avian influenza A(H10N5) virus reported globally.

What is the deadliest infectious disease? ›

TB is the world's deadliest infectious disease (though briefly eclipsed by COVID-19), killing someone every 20 seconds. But, despite its massive fatality rate, TB rarely makes headlines. In fact, many people in wealthy Western countries have no idea what TB is.

What are the deadliest viruses? ›

The deadliest viruses in history
  • Smallpox.
  • Hantavirus.
  • Influenza.
  • Dengue.
  • Rotavirus.
  • SARS-CoV.
  • SARS-CoV-2.
  • MERS-CoV.
Oct 19, 2022

What are signs your body is fighting a virus? ›

Symptoms of a viral infection depend on where you're infected, but some common ones include: Flu-like symptoms: fever, head and body aches, fatigue. Upper respiratory symptoms: sore throat, cough, sneezing. Digestive symptoms: nausea, vomiting, diarrhea.

What was the worst virus in history? ›

Cholera, bubonic plague, smallpox, and influenza are some of the most brutal killers in human history. And outbreaks of these diseases across international borders, are properly defined as pandemic, especially smallpox, which throughout history, has killed between 300-500 million people in its 12,000 year existence.

What infectious diseases are of the most concern in the twenty-first century? ›

One of the important challenges for the 21st century is the development of safe and effective vaccines for the 3 greatest microbial killers worldwide: HIV/AIDS, malaria, and tuberculosis. These 3 diseases account for one-third to one-half of healthy years lost in less developed countries [3].

Was COVID a pandemic or epidemic? ›

The number of people affected was exponentially growing and the World Health Organization (WHO) upgraded COVID-19 to a pandemic in March 2020. Pandemics are known to cause large-scale social disruption, economic loss, and general hardship, and COVID-19 has been no exception.

What is the difference between illness X disease? ›

Disease refers to a malfunctioning of biological and/or psychological processes, while the term illness refers to the psychosocial experience and meaning of perceived disease.” (Kleinman, 1980, p.

What are the symptoms of the mystery virus in 2024? ›

Written by Victoria Stokes on March 5, 2024 — Fact checked by Jill Seladi-Schulman, Ph. D. A “mystery virus” has been gaining traction on TikTok, with many social media users saying they are experiencing a litany of symptoms, including congestion, light-headedness, and shortness of breath.

What is the most difficult disease to diagnose? ›

Following is a list of the top 10 diseases that can be difficult to diagnost.
  1. Pulmonary embolus. ...
  2. Necrotizing fasciitis. ...
  3. Vascular pathology in the neck. ...
  4. Compromise of the spinal cord. ...
  5. Ischemic bowel. ...
  6. Sleep apnea and post-op hypoventilation. ...
  7. Compartment syndrome. ...
  8. Perforated or injured bowel post procedure.

What diseases are no longer a threat? ›

Two infectious diseases have successfully been eradicated: smallpox in humans, and rinderpest in ruminants. There are four ongoing programs, targeting the human diseases poliomyelitis (polio), yaws, dracunculiasis (Guinea worm), and malaria.

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