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Thinking about the next pandemic keeps many researchers busy.

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Peter Zelei Image / Getty Images


Thinking about the next pandemic keeps many researchers busy.

Peter Zelei Image / Getty Images

Just three years ago, on January 30, 2020, the head of the World Health Organization offered a turning point manifesto: A “new coronavirus” first identified in China has spread to the point where it is now a “Public Health Emergency of International Concern (PHEIC).”

The virus now known as SARS-CoV-2 — which causes the disease COVID-19 — is still spreading. But for those who study infectious diseases, talking about possible next pandemics is a necessity.

Hidden virus: how the pandemic really started

NPR is working on a series on viral contagion — that’s when pathogens from animals get into people. Researchers used to think spillovers were rare events. Now it’s clear that they happen all the time. That has changed the way scientists look for new deadly viruses. To find out more, we went to Guatemala and Bangladesh, Borneo and South Africa.

Send your question about spillover to [email protected] with “spread” in the subject line. We will answer the questions in the next post when the series ends in mid-February.

That’s why the World Health Organization keeps a list of viruses and bacteria with pandemic potential. Weather Jill of Baylor College of Medicine says that prioritizing diseases is often based on two factors: their ability to spread and people’s ability to treat them.

This list helps guide scientists, governments, and organizations investing energy and funds to research pathogens that are most likely to cause the most havoc to humans. WHO develops”the design” with strategic goals and research priorities for each disease on the list.

Below are the diseases on the current list. A list of revisions is expected in the coming months: End of 2022The World Health Organization convened more than 300 scientists to evaluate and update the list.

Note: The infrastructure for disease detection in different parts of the world is different, as is the fact that mild cases of illness may be unknown or unreported. Mortality rates are based on the best available data.

Nipah virus

Which animal carries it: fruit bats, including those known as flying foxes and domestic animals such as pigs, horses, cats, and dogs

How it spreads: Nipah virus can be transmitted to humans from contaminated animals or food. It can also be transmitted directly from person to person.

Its fee: Mortality rate 40% to 75%. The virus can also cause encephalitis or brain swelling.

Medical tool box: There is no vaccine available for humans or animals. Monoclonal antibody therapy is under development.

Pandemic risk: Outbreaks occur almost every year in parts of Asia, but there are known ways to prevent the spread of the virus. Prevention efforts include avoiding contact with bats and sick animals, avoiding fruit that bats may have eaten, and not drinking certain types of fresh juices that bats eat. The risk of international transmission can be reduced by thoroughly washing such fruits and fruit products and peeling them before eating.

Crimean-Congorian hemorrhagic fever

Which animal carries it: ticks, cattle

How it spreads: Humans often contract the virus from contact with infected ticks or livestock. To catch the virus from another person, close contact with the blood or other body fluids of an infected person is required.

Its fee: Mortality rates range from 10% to 40%. The disease is endemic, which means it occurs frequently, in Africa, the Balkans, the Middle East, and Asia. This virus causes severe outbreaks of viral hemorrhagic fever, a condition that can damage the body’s organ systems and cardiovascular system and often includes severe bleeding .

Medical tool box: Although a vaccine is being used in Bulgaria, there are no published studies on the effectiveness of this vaccine and it is not licensed anywhere else. Other vaccines are in development, and an antiviral called ribavirin seems to help treat the infection.

Pandemic risk: It’s difficult to know when an animal is infected and should be avoided, and the WHO says ticks carry the virus in abundance and spread. The threat can be reduced by trying to avoid tick bites and wearing gloves and other protective clothing around livestock.

lassa sauce

Which animal carries it: Rats and other rodents

How it spreads: This virus is endemic to parts of West Africa. Rats excrete the virus, and humans contract the virus when exposed to rodent urine and feces, through direct contact or eating contaminated food. It can also spread from person to person through direct contact with an infected person’s secretions (blood, urine, feces), through sexual contact, and in medical settings through contaminated equipment infected.

Its fee: 1%, but up to 15% in severe hospitalizations. It can be fatal to humans and fetuses during the third trimester of pregnancy. Besides death, a common complication is deafness, which can be permanent.

Medical tool box: There is no vaccine, but ribavirin seems to help treat the infection.

Pandemic risk: Since the primary mode of transmission is contact with a certain type of rat, the ability of the disease to spread is most likely limited to the countries where the rats live.

Valley Rift Sauce

Which animal carries it: mosquito. Insects can transmit viruses to both humans and their offspring. Cattle such as cattle, sheep, goats, buffalo and camels can also be infected.

How it spreads: It is spread to humans through contact with the blood, other body fluids, or tissues of infected animals.

Its fee: Although the mortality rate is less than 1% and the disease is mild for most people, about 8% to 10% of infected people develop severe symptoms, including eye damage, encephalitis, and dengue fever.

Medical tool box: Although a vaccine has been developed, it is not yet licensed or available.

Pandemic risk: Rift Valley fever has spread from Africa to Saudi Arabia and Yemen. Flooding seems to be contributing to the Rift Valley fever as more infected mosquitoes buzz after heavy rains. Rapid case detection, including rapid laboratory testing of people with symptoms, has limited recent outbreaks.

zika

Which animal carries it: mosquito

How it spreads: In addition to mosquito bites, the virus can be spread from a pregnant woman to her unborn baby. The disease can also be transmitted sexually and possibly through blood transfusion.

Its fee: It is rarely fatal, but Zika can cause serious brain defects in an unborn baby, including microcephaly. It has also been linked to miscarriages, stillbirths, and other birth defects.

Medical tool box: There is no treatment or vaccine

Pandemic risk: So far, it has been mainly limited to areas where Zika virus-carrying mosquitoes live.

Ebola and Marburg virus disease

The animals that carry them: Bats and non-human primates are thought to carry the virus, which belongs to the filovirus family, that causes these hemorrhagic fevers.

How they spread: Both viruses are thought to spread in the same way. After initial transmission from animals, humans spread the virus to others through direct contact with the blood or other body fluids of a person who has symptoms or who has died of the disease. The virus can also spread through objects or surfaces contaminated with bodily fluids and through the semen of people who have recovered from the disease.

Their phone number: The average mortality rate is around 50%, although it has varied from 25% to 90% in previous outbreaks.

Medical tool box: The vaccine has been used for Ebola in Guinea and the Democratic Republic of the Congo. Monoclonal antibodies approved by the Food and Drug Administration in 2020 may also help treat Ebola. A vaccine for the Marburg virus is under development.

Pandemic risk: These viruses can spread rapidly in healthcare settings, especially when proper disinfection is not used. However, the disease is only spread when a person has symptoms, so it is easier to control.

MERS (Middle East Respiratory Syndrome)

Which animal carries it: camel

How it spreads: After the initial event of camel-to-human transmission, this coronavirus can spread from person to person through close contact with an infected person.

Its fee: The reported mortality rate, according to WHO, is 35%.

Medical tool box: Several vaccines are in development, but none have been approved yet.

Pandemic risk: 27 countries have reported infections since 2012. Unlike SARS-CoV-2, the coronavirus that causes MERS grows deep in the respiratory tract, making it less likely to be transmitted through sneezing and cough.

SARS (severe acute respiratory syndrome)

Which animal carries it: Civets are largely blamed for the 2003 outbreak. Bats and possibly other wildlife also carry it.

How it spreads: After the event of initial animal-to-human transmission, SARS can spread from person to person through close contact with an infected person. It is believed that it is usually spread through droplets when coughing and sneezing and sometimes through surfaces touched by an infected person.

Its fee: less than 1% mortality

Medical tool box: There is no approved treatment or vaccine.

Pandemic risk: Unlike SARS-CoV-2, which can spread before people know they are infected, this SARS virus is usually only spread by people with known symptoms, making containment much easier. through public health measures such as isolation. The 2003 outbreak was contained after causing about 8,000 infections and 700 deaths in 29 countries.

Illness

The WHO said it did not rank diseases in any order of potential threat, but it acknowledged the possibility that an unknown disease could cause a serious pandemic.

In her work with the bat virus, for example, Raina Plowright of Cornell University says that even in the small percentage of bat species that have been studied, these animals carry thousands of viruses, “and we don’t know how much danger there is. current body,” she said. “We don’t have the technology to sequence it and say for sure if it’s infectious or human-to-human. We’re really blind.”

Not to mention that variations pose threats, she said. “Even the smallest genetic change can have profound effects. What if we had [a pathogen] with 50% mortality effectively conveyed?”

Sheila Mulrooney Eldred is a freelance medical journalist in Minneapolis. She has written about COVID-19 for many publications, including The New York TimesKaiser Health News, Medscape and washington articles. Than sheilaeldred.pressfolios.com. On Twitter: @milepostmedia.

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