UKHSA has revealed the most dangerous pathogens for Britain as one scientist warns a measles-like virus would ‘pose a threat far worse than Covid’ and be ‘impossible to control’
Britain has outlined four dangerous emerging viruses which could become the so-called “Disease X” to cause the next pandemic.
The UK Health Security Agency has revealed the virus families which pose the biggest pandemic risk and warns some are very little understood. One leading scientist has warned that one virus poses a “threat far worse than Covid… impossible to control by even the strictest lockdown”. The UKHSA has given a risk rating of high, moderate, or low pandemic potential for 24 virus groupings. Scientists have considered how infectious emerging new versions from these virus families could be, how severe disease they could cause and how vulnerable Britain is to them.
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The UKHSA risk rating specifically factors in the danger each pathogen poses to Britain in particular, given its geographical location, population demographics and available treatments. Four virus groups were found to have a high pandemic risk. They are:
- The Paramyxoviridae family which includes measles and the Nipah virus which can cause swelling of the brain and death
- The Picornaviridae family which causes enteroviruses that trigger polio-like diseases. One called acute flaccid myelitis (AFM) triggers muscle weakness and paralysis
- The Coronaviridae family which includes coronaviruses such as Covid-19 and MERS, which is common in the Middle East
- The Orthomyxoviridae family which causes forms of influenza including bird flu
The Paramyxoviridae family includes measles-like viruses which can cause deadly brain swelling. Large measles outbreaks are already being reported around the world as vaccination rates drop. Complications can include pneumonia, eye inflammation and vision loss as well as brain inflammation – encephalitis – which can lead to seizures, hearing loss and brain damage.
Mark Woolhouse, professor of infectious diseases at Edinburgh University, said: “A novel measles-like virus would pose a threat far worse than Covid. Such a virus would have a much higher R number than the original variants of Covid – making it impossible to control by even the strictest lockdown. It would also be considerably more deadly, and unlike Covid, it would be a threat to children. This is the kind of pandemic that public health agencies around the world are most concerned about.”
Measles has also been shown to wipe the memory of our immune systems so a large outbreak would likely be followed by a national surge in many other infections. A Harvard Medical School study in 2019 showed measles wiped out up to three-quarters of antibodies protecting against viruses or bacteria that a child was previously immune to.
The Paramyxoviridae family also includes the Nipah virus which has caused outbreaks in South East Africa and Southeast Asia. It can also cause a fatal swelling of the brain after a fever, headache, cough, sore throat and difficulty breathing.
The UKHSA’s ‘Priority Pathogens’ framework also listed the Picornaviridae family of viruses as high risk. One of them is the enterovirus which can cause a disease similar to polio called acute flaccid myelitis (AFM). It affects the spinal cord, causing sudden weakness and loss of reflexes which can result in paralysis and is most common in children.
Dr Isabel Oliver, chief scientific officer for UKHSA, said: “Infectious diseases don’t respect borders so all of this has an international dimension. In the context of the changing climate and other threats there are a wide range of pathogens that could cause the next pandemic.”
Unlike other international virus threat registers, the UKHSA has factored in a combination of a pathogen’s known risk of causing a future pandemic as well as the risk linked to a lack of understanding about it. Some have a high rating because they are largely unknown due to very little research being conducted on them so do not have available tests, vaccines or treatments should it become widespread.
Some pathogens’, including bacteria, have their risk increased because they are becoming resistant to our antibiotics or climate change means the country is becoming more hospitable for them. The UKHSA aims to direct national funders of research and development towards these to help create diagnostics, vaccines and therapeutics against them.
Dr Oliver added: “This tool is a vital guide for industry and academia, highlighting where scientific research can be targeted to boost UK preparedness against health threats. We are using the tool as part of our conversations with the scientific community, to help ensure that investment is focused to where it can have the biggest impact. We hope this will help to speed up vaccine and diagnostics development where it is most needed, to ensure we are fully prepared in our fight against potentially deadly pathogens.”
Among the UKHSA’s concerns is the distribution of disease-causing mosquitoes and ticks due to climate and environmental change, according to Dr Oliver. She added: “So that means the change in the distribution of mosquitoes and ticks that can carry viruses that cause adverse health effects to humans, and also to animals in some ways, and that is one area that we’re monitoring very closely. The UKHSA maintains surveillance of mosquitoes and ticks, and we work with partners in local government and animal health and other sectors to really understand any changes that might potentially affect our health in the UK.”
Professor Woolhouse added: “There are many potential kinds of novel pandemic threats – so-called Disease X – and the UKHSA report is a timely reminder that we should not put all our eggs in one basket. Our response needs to be scalable, adaptable and quick. Knowledge, information and data collected in the first few weeks of the next pandemic will be crucial to tailoring our response appropriately. We need the systems to gather that data in place in advance and ready to be activated, possibly at very short notice.”
Professor Robert Read, of Southampton University and Editor in Chief of the Journal of Infection, said: “Lists like this have been made for many years, and they represent an effort to prioritise infections for advisory and funding purposes, ostensibly to align research funding as closely as possible to public health need. Unfortunately, pathogens emerge or change constantly, and it is difficult to predict big infectious disease problems coming down the line.
“For this reason, I think this list is at best pointless, and at worst potentially harmful to the public health. Pointless because the list of viruses is so long that its tricky to name a significant viral pathogen that has not been included. Potentially harmful because a prescriptive list like this could misdirect funding towards certain infections, and away from problems that need urgently to be solved.”
A separate report co-authored by Sir Jonathan Van-Tam is demanding better international sharing of data to track dangerous new Covid-19 variants. The paper by the former deputy chief medical officer for England during the pandemic warns there is “public fatigue” towards Covid-19, stressing it continues to pose a risk to the elderly and vulnerable. It comes after the Mirror published a survey of 15,000 Brits showing four in ten now believe the country was wrong to go into lockdown.
Professor Van Tam said: “Great scientific progress has been made since COVID-19 emerged five years ago when we started with limited knowledge to fight the virus. Today, we have a range of effective tools including vaccines, tests and treatments available that remain key in the current endemic and to protect at risk groups. Healthcare leaders need to be vigilant and ensure that best practice, data and information continues to be shared between clinicians and policymakers to strengthen countries’ preparedness for new variants and any future challenges.”