12 pathogens with Severe epidemic or pandemic potential to watch: By Dr. Mahboob Khan

 We're almost halfway through 2023, with new public health challenges on the horizon.

I've compiled a list twelve pathogens with severe epidemic or pandemic potential to watch:

1. H5N1 bird flu: The H5N1 virus continues to evolve, reaching previously unaffected regions. Huge numbers of affected mammals in South America, together with record-breaking outbreaks in the west, are causing concern among scientists.

2. Other bird flu viruses: Human health is threatened by other avian influenza viruses such as H3N8, H5N5, H5N6, H5N8, H7N4, H7N9, H9N2, and H10N3.

3. MERS: MERS was discovered in Middle east in 2012 and is endemic in Camels on the Peninsula. The virus, which resembles SARS, has a fatality rate around 50%, but human to human transmission is limited.

4. New coronaviruses: First we had SARS in 2002, then we discovered MERS in 2012 and finally had COVID-19 discovered in 2019. New Coronaviruses characterized by high fatality rates seem to be the new normal.

5. Dengue fever: With climate change, dengue fever outbreaks have become more severe and widespread in tropical areas where the mosquito-borne illness is endemic. Rising temperatures increase the risk of the virus affecting previously unscathed regions.

6. Measles: Lower vaccination rates in many countries have made this highly infectious virus rise to levels not seen since the early 2,000s.

7. Ebola & Marburg: In recent years we have seen improvements regarding Ebola response with a vaccine available for use in case of outbreaks. Sudan Ebolavirus, however, has no approved vaccine. Ebola’s cousin, Marburg, suffers from the same issue.

8. Nipah virus: Nipah was discovered in 1998 and caused extensive outbreaks in Malaysia when people had direct contact with infected pigs. The virus later became endemic to fruit bats living in Bangladesh, with small outbreaks every year.

9. Bioterrorism: Anthrax can be used by terrorists and nations alike. After 9/11, "Anthrax letters” were sent to officials, killing five. Smallpox, which is eradicated in humans, only officially exists in two laboratories, at the CDC in Atlanta, and in Russia.

10. Mpox Low vaccination rates among at-risk populations, together with escalating outbreaks in Africa, could lead to a resurgence of the disease in big parts of the world.

11. Covid-19 The long term evolution of the virus is unknown, with new mutations sparking new waves of disease. If a severe mutation occurs, many countries will be uninterested in introducing mitigation measures due to political controversy.

12. Disease X: A pathogen currently unknown to humans. Climate change increases the risk of novel pathogens appearing. Increased human density, together with animals displaced from their natural habitat, could spell disaster when the wrong human meets the wrong animal.