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

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

What is X disease caused by? ›

It's likely to be a virus, not bacteria or fungus. It's likely to be something that could spill over from an animal species into a human. Or it could be a human pathogen that develops new characteristics or changes its genetics in such a way that makes it more conducive to causing a pandemic.

Should I be worried about Disease X? ›

Don't panic! Disease X doesn't exist yet – but it might one day. Disease X is the label that the World Health Organization uses to refer to some currently unknown infectious condition that is capable of causing an epidemic or – if it spreads across multiple countries – a pandemic.

How can we prevent Disease X? ›

As an elusive pathogen, we are unable to prevent the occurrence of Disease X. However, by implementing preventative measures, we may be able to impede or minimize its transmission and possible health risks. In order to achieve this, a universal scientific protocol for managing Disease X would be required.

Will there be a next pandemic? ›

The number of pathogens that could trigger the next pandemic has grown to more than 30, and now includes influenza A virus, dengue virus and monkeypox virus, according to an updated list published by the World Health Organization (WHO) this week.

What is the new virus called? ›

But SARS-CoV-2, the coronavirus that causes COVID, is still mutating, raising concerns about a potential wave of infections this summer. In April, a group of new virus strains known as the FLiRT variants (based on the technical names of their two mutations) began to spread, followed in June by a variant known as LB.1.

What is the virus in Mexico 2024? ›

As was previously reported, on 23 May 2024, the Mexico International Health Regulations (IHR) National Focal Point (NFP) reported to PAHO/WHO a confirmed case of human infection with avian influenza A(H5N2) virus in a patient with underlying co-morbidities who subsequently died.

What is the 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.

Is the COVID pandemic still happening? ›

COVID-19. As of July 30, 2024, we estimate that COVID-19 infections are growing or likely growing in 35 states and territories, declining or likely declining in 2 states and territories, and are stable or uncertain in 7 states and territories.

What is the difference between illness X disease? ›

Patients suffer "illnesses"; doctors diagnose and treat "diseases". Illnesses are experiences of discontinuities in states of being and perceived role performances. Diseases, in the scientific paradigm of modern medicine, are abnormalities in the function and/or structure of body organs and systems.

What are diseases that start with X? ›

Xa–Xk
  • Xanthic urolithiasis.
  • Xanthine oxydase deficiency.
  • Xanthinuria.
  • Xanthomatosis cerebrotendinous.
  • Xerocytosis, hereditary.
  • Xeroderma.
  • Xeroderma pigmentosum. Xeroderma pigmentosum, type 1. Xeroderma pigmentosum, type 2. Xeroderma pigmentosum, type 3. Xeroderma pigmentosum, type 5. ...
  • Xeroderma talipes enamel defects.

What is the best way to stop diseases from spreading? ›

Washing or sanitising your hands is one of the easiest ways to keep yourself and others safe. By keeping your hands clean, you can prevent the spread of germs and viruses. This is especially important if you are visiting people at higher risk. Wash your hands often with soap and water for 20 seconds.

What is the #1 way to prevent disease? ›

Good hygiene: the primary way to prevent infections

Wash your hands well. You probably wash your hands after using the bathroom, before preparing or eating food, and after gardening or other dirty tasks.

What is the likelihood of another pandemic? ›

An estimated 28 million excess deaths worldwide have been attributed to the covid pandemic, and the report says that there is around a 50% chance of another pandemic happening on the same scale in the next 25 years.

What is the new strain of the flu? ›

The virus involved in the current human influenza outbreak and also found in a pig herd in Canada, is a new strain. of the H1N1 influenza virus. It contains genes from pig, avian and human influenza viruses in a combination that has never been observed before.

How many times has there been a pandemic? ›

6) Increases in human population. There have been 249 Pandemics throughout recorded history from 1,200 BC, up to the Covid- 19 virus today.

What is fragile X caused by? ›

Fragile X syndrome (FXS) is a genetic disorder caused by changes in a gene called fragile X messenger ribonucleoprotein 1 (FMR1). FMR1 usually makes a protein called FMRP that is needed for brain development. People who have FXS do not make this protein.

What is the X disease in children? ›

The genetic disorder Fragile X syndrome, which results from mutations in a gene on the X chromosome, is the most commonly inherited form of developmental and intellectual disability.

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