Even if it doesn’t exist yet, it scares more than any other pathology. This is why the so-called “Disease
The good news, at least for the moment, is that this pathology is only a hypothesis, feared already in 2017 by the World Health Organization (WHO) to refer to some infectious conditions, currently unknown, which may be capable of causing a epidemic or, if it spreads to more countries, a pandemic.
The definition of Disease
Disease X is in fact a term coined to indicate a pathogen with pandemic potential. According to this definition, Covid-19 was the first Disease X. But there could be another in the future. “Some believe this could generate panic,” says the WHO director general Tedros Adhanom Ghebreyesus. “No. It’s better to anticipate something that might happen—because it has happened many times in history—and prepare,” she adds.
The over 300 scientists who were gathered by the WHO as early as November 2022 hypothesized that this future pathology could cause 20 times more deaths than Covid. “We have known the Zika virus, Ebola and we know what can happen,” emphasizes Tedros. “But we must have a plan for a future and unknown ‘Disease X’, which we have been talking about for many years. Covid – he continues – was the first Disease X, but it can happen again and we must be able to anticipate and prepare for this. Having an early warning system, knowing how to quickly expand health systems and investing more in primary care.”
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What pathogen will trigger it?
We therefore do not know what the pathogen responsible for the next Disease X will be. Coronaviruses are certainly among the main candidates. They already were before Covid-19. Also because in 2002 another coronavirus began to spread in China, causing a form of pneumonia called SARS that killed about one in 10 people among those it affected, before there had been time to control it with strict measures. Another even more deadly coronavirus, called MERS, which we still occasionally hear about, causes pneumonia that kills one in three infected people.
However, recent studies suggest that both SARS and MERS would have more difficulty triggering a new pandemic today, because almost everyone in the world has antibodies against the virus that causes Covid-19 and these appear to provide partial protection against most other agents. pathogens of the coronavirus family.
But there are many diseases, some well known and some less familiar, that could pose a global threat. In the past, influenza strains have caused several global pandemics, including one of the deadliest epidemics ever, the “Spanish flu” of 1918. Today, a virulent strain of avian influenza is spreading around the world and occasionally spreads from birds to mammals, causing mass deaths. Just this week, avian flu was officially linked to the deaths of 17,000 baby elephant seals in Argentina last October. Then there are other candidates for Disease X, such as Ebola, which causes severe bleeding, and the mosquito-borne Zika virus, which can cause babies to be born with smaller heads if infection occurs during pregnancy. WHO has updated the list of pathogens with the greatest pandemic potential in 2022.
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What weapons do we have?
Thankfully, the Covid-19 pandemic may have made it easier to stop any future Disease X. Covid-19 has spurred the development of new vaccine designs, including some that can be rapidly repurposed to target new pathogens. It led, for example, to the advent of mRNA-based vaccines. This formula contains a short piece of genetic material that causes the body’s immune cells to produce the coronavirus “spike” protein. But this formula could be updated to make cells produce a different protein, simply by rewriting the mRNA sequence.
According to the WHO director general, countries need better early warning systems for new diseases and health services must become more resilient to unexpected events.
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Surveillance systems
“In this situation it is essential to implement a syndromic surveillance system that is essentially based on the careful and continuous monitoring of the population to which the health system refers”, he explains Giovanni Orengo, specialist in Hygiene and Preventive Medicine, as well as medical director of the IRCCS San Martino Polyclinic Hospital in Genoa. “For some time now the Liguria Region, San Martino in particular, have been implementing this surveillance system which is based on the analysis of the symptoms with which our population comes to our emergency rooms – he continues. also using a certain number of doctors sentinels who provide their action to ensure the monitoring of patients who present particular symptoms which may refer to situations of respiratory infections of particular interest. This surveillance method probably represents the cornerstone of the framework with which we can think of preventing situations such as those foreseen by Disease
Be ready
Surveillance, however, is not enough. “When hospitals were exploited beyond their capacity (with Covid, ndr), we lost a lot of people because we couldn’t handle them,” Tedros points out. “There wasn’t enough space, there wasn’t enough oxygen,” he adds. To prevent the same thing from happening when the next Disease X hits, Tedros says that health services must be able to expand their capacity on demand. Fortunately, they can make these preparations without knowing exactly what Disease , he concludes.