Disease X: Health agencies worldwide on guard for hypothetical next pandemic

PETALING JAYA: The world is on its guard for another potential pandemic that international experts have warned could be at least several times more deadlier than Covid-19.

This hypothetical virus that had yet to emerge has been called Disease X.

According to the World Health Organisation (WHO), Disease X was a placeholder name adopted in 2018, for the pathogen that could cause a future pandemic.

It represented the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease.

WHO had classified Disease X among a host of priority pathogens that needed investment and research.

This list included the likes of Covid-19, Crimean-Congo haemorrhagic fever, Ebola virus disease and Marburg virus disease, Lassa fever, Middle East respiratory syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS), Nipah and henipaviral diseases, Rift Valley fever and Zika.

During the World Health Assembly held in Geneva, Switzerland, last May, WHO director-general Dr Tedros Adhanom Ghebreyesus said while the Covid-19 pandemic was far from over, the threat of the emergence of another variant which could cause new surges of disease and death, remained.

"And the threat of another pathogen emerging with even deadlier potential remains."

"When the next pandemic comes knocking — and it will — we must be ready to answer decisively, collectively and equitably."

"We cannot kick this can down the road. If we do not make the changes that must be made, then who will? And if we do not make them now, then when," he added.

He also called for updated negotiations on the International Health Regulations, a treaty which outlined the preparedness and responses to health crises, "so the world will never again have to face the devastation of a pandemic like Covid-19."

Former head of the UK’s Vaccine Taskforce Head Dame Kate Bingham said in a column published in the Daily Mail on Sept 22, that the next major pandemic was coming.

"It’s already on the horizon, adding that it could be far worse and killing millions more people than the last one.

"We don’t yet know for certain what form it will take — just that its arrival, according to global health experts, is not just a possibility but a probability," she said.

"To combat Disease X — as WHO ominously calls it — we will once again need vaccines to be engineered and delivered in record time.

"But, as things stand, there is absolutely no guarantee that will happen."

"Imagine Disease X is as infectious as measles with the fatality rate of Ebola. Somewhere in the world, it’s replicating, and sooner or later, somebody will start feeling sick," she added.

She added that vaccines might not be the only answer, adding that there must be investment into state-of-the-art systems for international surveillance of prospective virus threats.

"Ideally, Disease X will be neutralised before it starts spreading across the globe and mutating (which it certainly will, if left unchecked)," she said.

Meanwhile, a 2021 study entitled "Disease X: A hidden but inevitable creeping danger" published in the US National Institute of Health’s Library of Medicine noted that the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) and Zika had met the standards to be considered the first Disease X.

However, it added that Covid-19 and other recent pandemics might have just have been milder versions of what was expected to 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 a ribonucleic acid (RNA) virus, emerging from an area where the right mix of risk factors highly promotes the risk for sustained transmission," it said.

It added that while emerging zoonotic pathogens are a threat that needs to be monitored, the possibility of an engineered pandemic pathogen also could not be completely ignored.

"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," it added.

On Tuesday (Sept 26), Health Minister Dr Zaliha Mustafa said the ministry was always on the alert for any possible new pandemic, including the so-called "Disease X".

She said WHO would alert its member countries should there be any outbreak of a new disease.

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