Editing Pandemic (section)

== Concerns about future pandemics ==
{{See also|Pandemic prevention}}
Prevention of future pandemics requires steps to identify future causes of pandemics and to take preventive measures before the disease moves uncontrollably into the human population.

For example, influenza is a rapidly evolving disease which has caused pandemics in the past and has the potential to cause future pandemics. WHO collates the findings of 144 national influenza centres worldwide which monitor emerging flu viruses. Virus variants which are assessed as likely to represent a significant risk are identified and can then be incorporated into the next seasonal influenza vaccine program.<ref>{{cite web |date=3 November 2022 |title=Selecting Viruses for the Seasonal Flu Vaccine |url=https://www.cdc.gov/flu/prevent/vaccine-selection.htm |access-date=30 June 2023 |website=Centers for Disease Control and Prevention }}</ref>

In a press conference on 28 December 2020, Mike Ryan, head of the WHO Emergencies Program, and other officials said the current COVID-19 pandemic was "not necessarily the big one" and "the next pandemic may be more severe." They called for preparation.<ref>{{cite news|date=29 December 2020|title=WHO official: 'Next pandemic may be more severe'|url=https://arab.news/yx8p9|access-date=30 December 2020|website=Arab News}}</ref> WHO and the UN have warned the world must tackle the cause of pandemics and not just the health and economic symptoms.<ref>{{cite web| vauthors = Carrington D |date=9 March 2021|title=Inaction leaves world playing 'Russian roulette' with pandemics, say experts|url=http://www.theguardian.com/environment/2021/mar/09/inaction-leaves-world-playing-russian-roulette-pandemics-experts|access-date=10 March 2021|website=The Guardian}}</ref>

=== Diseases with pandemic potential ===
{{Further|Emerging infectious disease}}There is always a possibility that a disease which has caused epidemics in the past may return in the future.<ref name=":03"/> It is also possible that little known diseases may become more virulent; in order to encourage research, a number of organisations which monitor global health have drawn up lists of diseases which may have pandemic potential; see table below.{{Efn|As of June 2023, the WHO is reviewing its list}}
{| class="wikitable"
|+List of potential pandemic diseases according to global health organisations
!
![[World Health Organization|WHO]]<ref>{{cite web |date= |title=Prioritizing diseases for research and development in emergency contexts (Published 2018, revision in progress 2023) |url=https://www.who.int/activities/prioritizing-diseases-for-research-and-development-in-emergency-contexts |access-date=23 June 2023 |website=World Health Organization }}</ref>
![[Coalition for Epidemic Preparedness Innovations|CEPI]]<ref>{{cite web |date=23 June 2023 |title=Targeting diseases with epidemic and pandemic potential |url=https://cepi.net/research_dev/priority-diseases/ |access-date=23 June 2023 |website=CEPI, Coalition for Epidemic Preparedness Innovations }}</ref>
![[GAVI]]<ref>{{cite web |date=7 May 2020 |title=10 infectious diseases that could be the next pandemic {{!}} Gavi, the Vaccine Alliance |url=https://www.gavi.org/vaccineswork/10-infectious-diseases-could-be-next-pandemic |access-date=23 June 2023 |website=Gavi, the Vaccine Alliance }}</ref>
|-
|[[Chikungunya]]
|
|Yes
|
|-
|[[COVID-19]]
|Yes
|
|
|-
|[[Crimean–Congo hemorrhagic fever|Crimean-Congo haemorrhagic fever]]
|Yes
|
|Yes
|-
|[[Ebola|Ebola virus disease]]
|Yes
|Yes
|Yes
|-
|[[Lassa fever]]
|Yes
|Yes
|Yes
|-
|[[Marburg virus disease]]
|Yes
|
|Yes
|-
|[[Mpox]]
|
|
|Yes
|-
|[[MERS|Middle East respiratory syndrome]] coronavirus (MERS-CoV)
|Yes
|
|Yes
|-
|[[Nipah virus infection|Nipah]] and other [[Henipavirus|henipaviral]] diseases
|Yes
|Yes
|Yes
|-
|[[Rift Valley fever]]
|Yes
|Yes
|Yes
|-
|[[SARS|Severe Acute Respiratory Syndrome]] (SARS)
|Yes
|Yes
|Yes
|-
|[[Zika fever|Zika]]
|Yes
|
|Yes
|-
|[[Disease X]]{{Efn|Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease.}}
|Yes
|Yes
|
|}

==== Coronaviruses ====
{{Further|2002–2004 SARS outbreak|COVID-19 pandemic}}
[[File:Coronavirus virion.jpg|thumb|A generic coronavirus illustration]]
[[Coronavirus]] diseases are a family of usually mild illnesses in humans, including those such as the [[common cold]], that have resulted in outbreaks and pandemics such as the [[1889–1890 pandemic|1889-1890 pandemic]],<ref>{{cite journal | vauthors = Berche P | title = The enigma of the 1889 Russian flu pandemic: A coronavirus? | journal = Presse Médicale | volume = 51 | issue = 3 | pages = 104111 | date = September 2022 | pmid = 35124103 | pmc = 8813723 | doi = 10.1016/j.lpm.2022.104111 }}</ref><ref>{{Cite news |date=2022-02-14 |title=An Undiscovered Coronavirus? The Mystery of the 'Russian Flu' (Published 2022) |work=The New York Times |language=en |url=https://www.nytimes.com/2022/02/14/health/russian-flu-coronavirus.html |access-date=2023-07-29 |last1=Kolata |first1=Gina }}</ref> the [[2002–2004 SARS outbreak]], ''[[Middle East respiratory syndrome–related coronavirus]]'' and the [[COVID-19 pandemic]]. There is widespread concern that members of the coronavirus family, particularly [[SARS]] and MERS have the potential to cause future pandemics.<ref>{{cite web | vauthors = Heymann D, Ross E, Wallace J |date=23 February 2022 |title=The next pandemic – when could it be? |url=https://www.chathamhouse.org/2022/02/next-pandemic-when-could-it-be |access-date=24 July 2023 |website=Chatham House, The Royal Institute of International Affairs}}</ref> Many human coronaviruses have zoonotic origins, their with natural reservoir in bats or rodents,<ref name=":82">{{cite journal | vauthors = Forni D, Cagliani R, Clerici M, Sironi M | title = Molecular Evolution of Human Coronavirus Genomes | journal = Trends in Microbiology | volume = 25 | issue = 1 | pages = 35–48 | date = January 2017 | pmid = 27743750 | pmc = 7111218 | doi = 10.1016/j.tim.2016.09.001 | quote = Specifically, all HCoVs are thought to have a bat origin, with the exception of lineage A beta-CoVs, which may have reservoirs in rodents [2]. }}</ref> leading to concerns for future [[Spillover infection|spillover]] events.<ref>{{cite journal | vauthors = Holmes EC | title = COVID-19-lessons for zoonotic disease | journal = Science | volume = 375 | issue = 6585 | pages = 1114–1115 | date = March 2022 | pmid = 35271309 | doi = 10.1126/science.abn2222 | bibcode = 2022Sci...375.1114H | s2cid = 247384213 }}</ref>

Following the end of the COVID-19 pandemic Public Health Emergency of International Concern deceleration by WHO, WHO Director General [[Tedros Adhanom Ghebreyesus|Tedros Ghebreyesus]] stated he would not hesitate to re-declare COVID-19 a PHEIC should the global situation worsen in the coming months or years.

==== Influenza ====
{{Main|Influenza pandemic}}[[File:Barack Obama being briefed on swine flu oubreak 4-29.jpg|thumb|President [[Barack Obama]] is briefed in the Situation Room about the [[2009 swine flu pandemic|2009 flu pandemic]], which killed as many as 17,000 Americans.<ref>{{cite news |date=12 February 2010 |title=Swine flu has killed up to 17,000 in U.S.: report |work=Reuters |url=https://www.reuters.com/article/us-flu-usa/swine-flu-has-killed-up-to-17000-in-u-s-report-idUSN1223579720100212}}</ref>]][[Influenza]] was first described by the Greek physician [[Hippocrates]] in 412{{nbsp}}BC.<ref>{{cite web |title=50 Years of Influenza Surveillance |url=http://who.int/inf-pr-1999/en/pr99-11.html |archive-url=https://web.archive.org/web/20090501165850/http://www.who.int/inf-pr-1999/en/pr99-11.html |archive-date=1 May 2009 |work=World Health Organization}}</ref> Since the Middle Ages, influenza pandemics have been recorded every 10 to 30 years as the virus mutates to evade immunity.<ref>{{cite journal |vauthors=Potter CW |date=October 2001 |title=A history of influenza |journal=Journal of Applied Microbiology |volume=91 |issue=4 |pages=572–579 |doi=10.1046/j.1365-2672.2001.01492.x |pmid=11576290 |s2cid=26392163 |doi-access=free}}</ref><ref>{{cite web |date=12 December 2022 |title=How Flu Viruses Can Change |url=https://www.cdc.gov/flu/about/viruses/change.htm |access-date=12 July 2023 |website=Centers for Disease Control and Prevention}}</ref>

Influenza is an [[Endemic (epidemiology)|endemic disease]], with a fairly constant number of cases which vary seasonally and can, to a certain extent, be predicted.<ref>{{cite web |date=2 May 2023 |title=Key Facts About Influenza (Flu) |url=https://www.cdc.gov/flu/about/keyfacts.htm |access-date=12 July 2023 |website=Centers for Disease Control and Prevention}}</ref> In a typical year, 5–15% of the population contracts influenza. There are 3–5 million severe cases annually, with up to 650,000 respiratory-related deaths globally each year.<ref>{{cite web |title=Influenza (Seasonal) |url=https://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal) |access-date=12 July 2023 |website=World Health Organization }}</ref> The [[1889–1890 pandemic]] is estimated to have caused around a million fatalities,<ref name="Shally-Jensen_2010">{{cite book |title=Encyclopedia of Contemporary American Social Issues |date=2010 |publisher=[[ABC-CLIO]] |isbn=978-0-31339205-4 | veditors = Shally-Jensen M |volume=2 |page=1510 |chapter=Influenza |quote=The Asiatic flu killed roughly one million individuals |chapter-url=https://books.google.com/books?id=BjKWfAz0tx4C&pg=PA1510}}</ref> and the "[[Spanish flu]]" of 1918–1920 eventually infected about one-third of the [[world's population]] and caused an estimated 50{{nbsp}}million fatalities.<ref name="Taubenberger" />

The [[Global Influenza Surveillance and Response System]] is a global network of laboratories that has for purpose to monitor the spread of [[influenza]] with the aim to provide WHO with influenza control information.<ref name="Fange">{{cite book | vauthors = Lee K, Fang J |url=https://books.google.com/books?id=9zCEmpopjG0C&dq=%22WHO%22+%22GISRS+is+a%22&pg=PA163 |title=Historical Dictionary of the World Health Organization |year=2013 | publisher=Rowman & Littlefield |isbn=9780810878587}}</ref> More than two million respiratory specimens are tested by GISRS annually to monitor the spread and evolution of influenza viruses through a network of about 150 laboratories in 114 countries representing 91% of the world's population.<ref name="Leveraging">{{cite journal | vauthors = Broor S, Campbell H, Hirve S, Hague S, Jackson S, Moen A, Nair H, Palekar R, Rajatonirina S, Smith PG, Venter M, Wairagkar N, Zambon M, Ziegler T, Zhang W | display-authors = 6 | title = Leveraging the Global Influenza Surveillance and Response System for global respiratory syncytial virus surveillance-opportunities and challenges | journal = Influenza and Other Respiratory Viruses | volume = 14 | issue = 6 | pages = 622–629 | date = November 2020 | pmid = 31444997 | pmc = 7578328 | doi = 10.1111/irv.12672 | doi-access = free }}{{CC-notice|by4|url=https://onlinelibrary.wiley.com/doi/full/10.1111/irv.12672}}</ref>

=== Antibiotic resistance ===
{{Main|Antibiotic resistance}}

Antibiotic-resistant microorganisms, which sometimes are referred to as "[[Antibiotic resistance|superbug]]s", may contribute to the re-emergence of diseases with pandemic potential that are currently well controlled.<ref>{{cite web | url = http://www.pasteur.fr/actu/presse/press/07pesteTIGR_E.htm | title = Researchers sound the alarm: the multidrug resistance of the plague bacillus could spread | archive-url = https://web.archive.org/web/20071014012153/http://www.pasteur.fr/actu/presse/press/07pesteTIGR_E.htm| archive-date = 14 October 2007 | work = Pasteur.fr }}</ref>

For example, cases of tuberculosis that are resistant to traditionally effective treatments remain a cause of great concern to health professionals. Every year, nearly half a million new cases of [[multidrug-resistant tuberculosis]] (MDR-TB) are estimated to occur worldwide.<ref>[https://web.archive.org/web/20090406170131/http://www.who.int/mediacentre/news/releases/2009/tuberculosis_drug_resistant_20090402/en/index.html Health ministers to accelerate efforts against drug-resistant TB]. ''World Health Organization.''</ref> China and India have the highest rate of MDR-TB.<ref>[https://www.theguardian.com/society/2009/apr/01/bill-gates-tb-timebomb-china Bill Gates joins Chinese government in tackling TB 'timebomb']. ''Guardian.co.uk''. 1 April 2009</ref> WHO reports that approximately 50 million people worldwide are infected with MDR-TB, with 79 percent of those cases resistant to three or more antibiotics. Extensively drug-resistant tuberculosis ([[XDR TB|XDR-TB]]) was first identified in Africa in 2006 and subsequently discovered to exist in 49 countries. During 2021 there were estimated to be around 25,000 cases XDR-TB worldwide.<ref>{{cite web |title=Global Tuberculosis Report |url=https://www.who.int/teams/global-tuberculosis-programme/tb-reports |access-date=30 June 2023 |website=World Health Organization }}</ref>

In the past 20 years, other common bacteria including ''[[Staphylococcus aureus]]'', ''[[Serratia marcescens]]'' and ''[[Enterococcus]]'', have developed resistance to a wide range of [[antibiotics]]. Antibiotic-resistant organisms have become an important cause of healthcare-associated ([[Hospital-acquired infection|nosocomial]]) infections.<ref name=":8">{{cite journal |vauthors=Murray CJ, Ikuta KS, Sharara F, Swetschinski L, Aguilar GR, Gray A, etal |date=February 2022 |title=Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis |journal=Lancet |volume=399 |issue=10325 |pages=629–655 |doi=10.1016/S0140-6736(21)02724-0 |pmc=8841637 |pmid=35065702 |s2cid=246077406 |collaboration=Antimicrobial Resistance Collaborators}}</ref>

=== Climate change ===
{{Further|Effects of global warming on human health#Impact on infectious diseases}}
[[File:Aedes_aegypti_CDC9253.tif|thumb|''[[Aedes aegypti]]'', the mosquito that is the vector for [[dengue]] transmission.]]

There are two groups of infectious diseases that may be affected by climate change. The first group are [[vector-borne disease]]s which are transmitted via insects such as mosquitos or ticks.<ref>{{Cite book |last=Intergovernmental Panel on Climate Change (IPCC) |url=https://www.cambridge.org/core/product/identifier/9781009325844/type/book |title=Climate Change 2022 – Impacts, Adaptation and Vulnerability: Working Group II Contribution to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change |date=29 June 2023 |publisher=Cambridge University Press |isbn=978-1-009-32584-4 |edition=1 |pages=1041–1170 |doi=10.1017/9781009325844.009}}</ref> Some of these diseases, such as [[malaria]], [[yellow fever]], and [[dengue fever]], can have potentially severe health consequences. Climate can affect the distribution of these diseases due to the changing geographic range of their vectors, with the potential to cause serious outbreaks in areas where the disease has not previously been known.<ref name="The Mosquito's Bite">{{cite book | vauthors = Epstein PR, Ferber D |url= https://archive.org/details/unset0000unse_c1j4/page/29 |title=Changing Planet, Changing Health: How the Climate Crisis Threatens Our Health and what We Can Do about it |publisher=University of California Press |year=2011 |isbn=978-0-520-26909-5 |pages=[https://archive.org/details/unset0000unse_c1j4/page/29 29–61] |chapter=The Mosquito's Bite |chapter-url=https://books.google.com/books?id=nnOkFhXo8rEC&pg=PA29}}</ref> The other group comprises [[Waterborne diseases|water-borne]] diseases such as cholera, dysentery, and typhoid which may increase in prevalence due to changes in rainfall patterns.<ref>{{Cite journal | vauthors = Jung YJ, Khant NA, Kim H, Namkoong S |date=January 2023 |title=Impact of Climate Change on Waterborne Diseases: Directions towards Sustainability |journal=Water |language=en |volume=15 |issue=7 |pages=1298 |doi=10.3390/w15071298 |issn=2073-4441 |doi-access=free |bibcode=2023Water..15.1298J }}</ref>

=== Encroaching into wildlands ===
{{Further|Zoonosis#Biodiversity loss and environmental degradation|Human–wildlife conflict|Wildland–urban interface|Urban sprawl}}

The October 2020 'era of pandemics' report by the [[United Nations]]' [[Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services]], written by 22 experts in a variety of fields, said the anthropogenic destruction of [[biodiversity]] is paving the way to the pandemic era and could result in as many as 850,000 viruses being transmitted from animals—in particular [[birds]] and [[mammals]]—to humans. The [[Overconsumption|"exponential rise" in consumption]] and trade of commodities such as [[meat]], [[palm oil]], and metals, largely facilitated by developed nations, and a [[Population growth|growing human population]], are the primary drivers of this destruction. According to [[Peter Daszak]], the chair of the group who produced the report, "there is no great mystery about the cause of the Covid-19 pandemic or any modern pandemic. The same human activities that drive [[climate change and biodiversity loss]] also drive pandemic risk through their impacts on our environment." Proposed policy options from the report include taxing meat production and consumption, cracking down on the illegal wildlife trade, removing high-risk species from the legal wildlife trade, eliminating subsidies to businesses that are harmful to the natural world, and establishing a global surveillance network.<ref>{{cite news |date=29 October 2020 |title=UN report says up to 850,000 animal viruses could be caught by humans, unless we protect nature |work=[[The Conversation (website)|The Conversation]] |url=https://theconversation.com/un-report-says-up-to-850-000-animal-viruses-could-be-caught-by-humans-unless-we-protect-nature-148911 |access-date=1 December 2020 |vauthors=Woolaston K, Fisher JL}}</ref><ref>{{cite news |date=29 October 2020 |title=Protecting nature is vital to escape 'era of pandemics' – report |work=The Guardian |url=https://www.theguardian.com/environment/2020/oct/29/protecting-nature-vital-pandemics-report-outbreaks-wild |access-date=1 December 2020 |vauthors=Carrington D}}</ref><ref>{{cite news |author=<!--Staff writer(s); no by-line.--> |date=29 October 2020 |title=Escaping the 'Era of Pandemics': experts warn worse crises to come; offer options to reduce risk |work=EurekAlert! |url=https://www.eurekalert.org/pub_releases/2020-10/tca-et102820.php |access-date=1 December 2020}}</ref>

In June 2021, a team of scientists assembled by the [[Harvard Medical School Center for Health and the Global Environment]] warned that the primary cause of pandemics so far, the anthropogenic destruction of the natural world through such activities including [[deforestation]] and [[hunting]], is being ignored by world leaders.<ref>{{cite news |date=4 June 2021 |title=World leaders 'ignoring' role of the destruction of nature in causing pandemics |work=The Guardian |location= |url=https://www.theguardian.com/world/2021/jun/04/end-destruction-of-nature-to-stop-future-pandemics-say-scientists |access-date=4 June 2021 |vauthors=Carrington D}}</ref>

=== Melting permafrost ===
[[Permafrost]] covers a fifth of the northern hemisphere and is made up of soil that has been kept at temperatures below freezing for long periods. Viable samples of viruses have been recovered from thawing permafrost, after having been frozen for many years, sometimes for millennia. There is a remote possibility that a thawed pathogen could infect humans or animals.<ref>{{Cite journal |last1=Alempic |first1=Jean-Marie |last2=Lartigue |first2=Audrey |last3=Goncharov |first3=Artemiy E. |last4=Grosse |first4=Guido |last5=Strauss |first5=Jens |last6=Tikhonov |first6=Alexey N. |last7=Fedorov |first7=Alexander N. |last8=Poirot |first8=Olivier |last9=Legendre |first9=Matthieu |last10=Santini |first10=Sébastien |last11=Abergel |first11=Chantal |last12=Claverie |first12=Jean-Michel |date=18 February 2023 |title=An Update on Eukaryotic Viruses Revived from Ancient Permafrost |journal=Viruses |language=en |volume=15 |issue=2 |pages=564 |doi=10.3390/v15020564 |doi-access=free |pmid=36851778 |pmc=9958942 |issn=1999-4915}}</ref><ref>{{Cite news |last=Luhn |first=Alec |date=2016-08-01 |title=Anthrax outbreak triggered by climate change kills boy in Arctic Circle |url=https://www.theguardian.com/world/2016/aug/01/anthrax-outbreak-climate-change-arctic-circle-russia |access-date=2024-01-22 |work=The Guardian |language=en-GB |issn=0261-3077}}</ref>

=== Artificial intelligence ===
Experts have raised concerns that advances in [[artificial intelligence]] could facilitate the design of particularly dangerous pathogens with pandemic potential. They recommended in 2024 that governments implement mandatory oversight and testing requirements.<ref>{{Cite magazine |last1=Pillay |first1=Tharin |last2=Booth |first2=Harry |date=2024-08-27 |title=AI Could One Day Engineer a Pandemic, Experts Warn |url=https://time.com/7014800/ai-pandemic-bioterrorism/ |access-date=2025-01-09 |magazine=TIME |language=en}}</ref>