May was a bad month for infectious diseases, according to the ProMED website, the world’s largest open surveillance system for reporting outbreaks. And that has nothing to do with the monkey pox, which is now a lot of panic in the West. There are much worse things circulating in the world. Some new ones, much more disturbing ones too. But, even after the coronavirus warning, we still don’t seem to understand what’s hanging over our heads. And we also don’t seem to understand – or don’t want to face – what we need to do to avert a really serious pandemic.
In the past three weeks, there have been nearly 100 cases and 18 human deaths from a rare tick-borne disease in Iraq; a new outbreak of the Ebola virus and more than 100 cases of bubonic plague have been found in the Democratic Republic of Congo; and just two years after Africa was declared free of wild polio, new cases have emerged in Malawi and Mozambique. A dangerous form of typhoid is circulating in Nepal, India and China. There are alarming outbreaks on several continents of mosquito diseases such as malaria, dengue and West Nile virus.
In this global context, the so far very limited monkeypox outbreaks that have started to crop up over the past month – including 6 cases in Belgium – are only notable because they are reported in rich countries.
Animal pandemics are also on the rise. African swine fever continues to plague the world’s pigs and various types of deadly bird flu or bird flu are spreading, requiring the culling of hundreds of millions of poultry.
Vets and ecologists also warned this month about mysterious fungal diseases found in fish and marine life in Australia and countries in the Middle East, as well as deadly diseases in dogs and other pets.
It is no coincidence that 335 new deadly diseases have arisen since 1940
We are uncomfortable with many thousands of potentially deadly viruses circulating in other species, but what is remarkable is that most of the viruses that affect humans today were simply unknown not even 70 years ago. Not only are new pathogens increasingly jumping from animals to humans, but an increasing number are related to the changes we are causing as a species to the global and local environment. Climate change will exacerbate the rapid spread of viruses and pathogens as humans invade the natural world.
It is no coincidence that 335 new and potentially deadly diseases have emerged worldwide since 1940, during a period when the human population has tripled, the climate has changed and there has been a spectacular increase in meat consumption. Disease ecologists say that nothing increases the risk of a pathogen crossing from one species to another more than the uncontrolled expansion of agriculture and human exploitation of wild species.
The more humans have grown and we’ve encroached on wild areas or imposed unnatural conditions on other species, the more we’ve created the ideal environment for viruses and pathogens to spread, mutate, and spread across species. HIV, Ebola, Lassa fever and monkey pox in Africa; Sars and Covid-19 in China; chagas, machupo and hantavirus in Latin America; hendra virus in Australia; Mers in Saudi Arabia – all of them originated in the past 75 years, during a time when we have accelerated deforestation, moved to cities, increasingly encroached on animal habitats and created a global economy.
The biggest danger? A new bird flu
The most worrying thing for humans isn’t monkey pox, plague, or even Ebola, which sound dangerous and exotic, but are now more or less manageable with vaccines. Most worrying at the moment is the threat of a new bird flu, which could come from a farm in New York or within the EU just as likely as from China or Bolivia. Chicken is now the world’s most popular meat and tens of millions of nearly genetically identical birds prone to catastrophic disease, often raised in unsanitary conditions, can mingle with wild birds. It’s only a matter of decades (at best) before a new highly pathogenic avian flu strain develops to be easily transmissible between humans.
History shows that major flu pandemics with very high death rates occur every 30 years – an average that we are currently well passed. If we’re lucky, we’ll soon find a vaccine for the next one and she’ll only kill 10 to 20% of the people she infects. If we’re unlucky, it could be as transmissible as Omikron and as deadly as Ebola – in which case it would essentially be game over for much of humanity and the global economy.
Climate change makes things even worse
Climate change, meanwhile, is creating a warmer world and that has a potentially catastrophic impact on disease. Global warming is fundamentally changing the landscape of disease by forcing or enabling species to survive in new places and intermingle with others. Insects already kill about 700,000 people a year, but global warming allows mosquitoes, mites, fleas, ticks and other vectors to thrive in new areas, spreading dengue, chikungunya and other diseases to higher elevations or to previously cooler climates .
Canadian bacteriologists have shown how pathogens jump more easily to new, susceptible hosts in times of major historical environmental change – such as now. All they need is the ability to interact, and warming does just that. Once the pathogens have expanded into new hosts, new variants are more likely to appear, each with new infectious capacities.
So the situation looks bleak. But science and new technologies are catching up with vaccines for rare and neglected diseases, and global surveillance and early detection of potential virus spillovers in the wild have already improved significantly.
The most important key to save us from the next pandemic
But the main key to saving us from another, and potentially much worse, pandemic lies in investing heavily in public health systems in developing countries. They are the first line of defense and making sure it works is the surest precaution to contain disease. The monkey pox is a very good example of how we still don’t get it.
The virus — discovered five decades ago in the Democratic Republic of Congo — causes mild illness in most people, along with blisters that usually clear up within weeks. It is much less transmissible than the coronavirus and much less deadly than Ebola. There is already an effective vaccine.
Monkeypox perfectly illustrates the double standard we have when it comes to disease: nobody cared – including the media – until people in the West started getting sick.
In the past two weeks, cases of the animal-borne virus typically found in West and Central Africa have emerged in the United States, Canada, Australia, Israel and a growing number of European countries. “We” were all surprised. Despite the fact that several African countries have been battling outbreaks in recent months (and decades).
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