What is ‘Disease X,’ the disease COVID researchers say could be the next pandemic?

Updated: Jun. 21, 2023, 6:39 a.m.|Published: Jun. 21, 2023, 5:30 a.m.

Researchers at the World Health Organization say that "Disease X" — a placeholder for an unknown pathogen that causes human infections — might cause the next pandemic. (NIAID-RML via AP, File)AP

By Katherine Rodriguez | NJ Advance Media for NJ.com

The World Health Organization’s (WHO) list of diseases that could cause the next pandemic includes the ominous “Disease X.”

The pathogen “Disease X” is a new disease agent unknown to medical science that likely does not have any treatments or vaccines.

Researchers have to prepare for the unknown when it starts to spread.

“You cannot prevent an unknown pathogen from evolving into one that could lead to a pandemic,” Dr. Sandra Adams, a biology professor and virologist at Montclair State University, told NJ Advance Media.

However, researchers can use the knowledge they have gained to fight against pandemics.

“You can, however, use what we learned to combat the SARS-CoV-2 pandemic,” she added. The “availability of vaccines worldwide to prevent deaths and serious illness” and “mitigation strategies to reduce the spread” of COVID-19 “until vaccines were developed” were crucial in preventing the most recent pandemic from becoming much worse.

Most researchers believe the next “Disease X” will come from animals before infecting humans.

“If a ‘Disease X’ pathogen does evolve, it will likely be from a zoonotic RNA virus,” Adams said. “This means an RNA virus that resides in an animal will develop mutations that will allow it to infect human hosts.”

But they have not ruled out other sources, such as laboratory accidents or incidences of bioterrorism.

The WHO started using the term “Disease X” in 2018. It last used the term as COVID-19′s original name when the virus first began spreading across China.

“The COVID-19 pandemic was not the first to wreak havoc on the world and it will not be the last,” the authors of a 2021 article from the journal Infection Control & Hospital Epidemiology wrote. “Thus, we need to prepare for the next outbreak as soon as possible.”

Adams had a more positive outlook on the fate of “Disease X.”

“Hopefully, we will take the knowledge gained from battling SARS-CoV-2 to prevent ‘Disease X pathogen’ from becoming the next pandemic,” Adams said.

https://www.nj.com/healthfit/2023/06/what-is-disease-x-the-disease-covid-researchers-say-could-be-the-next-pandemic.html

What is ‘Disease X’? COVID experts warn it could cause deadlier pandemic

By Marc Lallanilla May 24, 2023 5:03pm Updated

The World Health Organization keeps a short list of “priority diseases” that could cause the next deadly pandemic.

Most of the diseases are already known to us — Ebola, SARS and Zika made the cut — but the final entry has the terrifying name “Disease X.”

The term Disease X is used by the WHO as a placeholder to describe a disease that’s unknown to medical science as a cause of human infections.

And as a new disease agent — whether it’s a virus, a bacterium, a fungus or other agent — there likely won’t be any vaccines or few, if any, treatments available.

“This isn’t the stuff of science fiction,” Dr. Richard Hatchett, of the Coalition for Epidemic Preparedness Innovations, told the Telegraph.

“This is a scenario we have to prepare for. This is Disease X.”

The WHO coined the term Disease X in 2018.

One year later, as COVID-19 began to spread across China, the world witnessed a deadly pandemic caused by a new virus — a Disease X had emerged.

The head of the World Health Organization makes a speech warning of the next pandemic.

The next pandemic ‘even deadlier’ than COVID is coming, warns WHO

“It is not an exaggeration to say that there is potential of a Disease X event just around the corner,”

Dr. Pranab Chatterjee, researcher at the Department of International Health at Johns Hopkins Bloomberg School of Public Health in Baltimore, told the National Post.

“The recent spate of H5N1 bird flu cases in Cambodia is just a case in point,” Chatterjee added.

Some public health experts believe the next Disease X will be zoonotic, meaning it will originate in wild or domestic animals, then spill over to infect humans.

Ebola, HIV/AIDS and COVID-19 were zoonotic outbreaks.

However, there are other sources of diseases and bioterrorism could be the cause of the next pandemic.

“The possibility of an engineered pandemic pathogen also cannot be ignored,” said the authors of a 2021 article in the journal Infection Control & Hospital Epidemiology.

“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,” the authors added.

Another possible source could be “zombie” viruses that have been locked in permafrost or other frozen landscapes for centuries, but are released by a warming climate.

The other priority diseases on the WHO list include Marburg virus, Crimean-Congo hemorrhagic fever, Lassa fever, Nipah and henipaviral diseases, Rift Valley fever and Middle East respiratory syndrome.

To prevent and combat an outbreak of Disease X, medical experts worldwide are clamoring for an increase in funds to support the surveillance of, and research into, potential pandemic agents.

“The COVID-19 pandemic was not the first to wreak havoc on the world and it will not be the last,” wrote the authors of the Infection Control & Hospital Epidemiology article.

“Thus, we need to prepare for the next outbreak as soon as possible.”

https://nypost.com/2023/05/24/what-is-disease-x-covid-experts-warn-it-could-cause-deadlier-pandemic/

Disease X: A hidden but inevitable creeping danger

Journal List Cambridge University Press - PMC COVID-19 Collection PMC8367867

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Inclusion in an NLM database does not imply endorsement of, or agreement with, the contents by NLM or the National Institutes of Health.

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Infect Control Hosp Epidemiol. 2021 Jul 26 : 1–2.

Published online 2021 Jul 26. doi: 10.1017/ice.2021.342

PMCID: PMC8367867

PMID: 34308811

Disease X: A hidden but inevitable creeping danger

Muhammad Junaid Tahir, MBBS, 1 Imaduddin Sawal, MBBS, 2 Mohammad Yasir Essar, MBBS, 3 Abdul Jabbar, MPhil, 4 Irfan Ullah, MBBS, 5 and Ali Ahmed, PhD 6

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.

Disease X: A hidden but inevitable creeping danger

Journal List Cambridge University Press - PMC COVID-19 Collection PMC8367867

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.

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]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8367867/

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