Throughout human history, disease outbreaks have emerged and re-emerged. What’s different now is that with global travel, outbreaks can move quickly among and between populations.
A familiar example would be the COVID-19 pandemic and how it disrupted the world as we know it today. During this period, a lot of technological advancements were achieved during a short time such as vaccine roll-out and also tracking of variants globally.
Since this pandemic, we have been constantly reminded of the threat that emerging infectious diseases pose, as well as new strains of existing microbes, and even infections that may eventually become untreatable. This should also serve as a constant reminder of the need to continue developing the tools and technology to fight them.
Infectious disease outbreaks since COVID-19
In 2022, shortly after the worst of the devastating COVID-19 pandemic had passed, the world was rocked by another infectious disease outbreak, which was soon classified as a public health emergency of international concern.
The culprit was mpox, then known as the monkeypox virus.
Unlike SARS-CoV-2, which causes COVID-19, this was not a novel virus but had been identified in laboratory monkeys in Denmark as far back as 1958. The first human cases were documented in 1970 among children in the Democratic Republic of Congo (DRC).
Since then, there have been multiple reported outbreaks of mpox, the majority of them limited to Africa. This includes a 2022 global outbreak that caused about 250 deaths, representing a fatality rate of 0.2 per cent.
An ongoing outbreak started in 2023 in Central Africa, claiming about 900 lives with a fatality rate of five per cent.
According to the World Health Organization, the two most recent mpox outbreaks were primarily driven by sexual transmission or body contact. There is currently no treatment approved by the FDA for mpox.
In early 2024, an avian influenza outbreak resurfaced in the United States when the viral infection that typically affects birds was detected in dairy cows for the first time. It has since spread to about 973 cattle in 17 states, and there have been about 70 human cases among people associated with farm animals.
Recently, a respiratory outbreak known as hMPV has been overwhelming hospitals in Northern China, with children, adolescents and senior citizens being at most risk. The origin of this outbreak is not yet known.
Untreatable sexually transmitted infection
Gonorrhoea is a widely known sexually transmitted infection (STI). Approximately 80 million people were infected by this bacterium in 2020. Though most cases remain treatable, an untreatable form of gonorrhoea is becoming more prevalent, threatening victims with infertility or even cancer.
Treatment failure can happen when a disease adapts to become resistant to antibiotics. Antibiotic resistance has significant implications for global health, including massive financial implications for health care.
An emerging STI threat
Other, uncommon but difficult to treat STIs are emerging. One is called Mycoplasma genitalium, the causative agent for non-gonococcal urethritis — a typically painful infection of the tube that carries urine from the bladder.
Read more: Antimicrobial resistance now hits lower-income countries the hardest, but superbugs are a global threat we must all fight
With symptoms similar to gonorrhoea, it can lead to infertility, increased susceptibility to HIV, failed pregnancy, cancer of the cervix and more. Yet, it is often misdiagnosed due to it being understudied and its complexity.
This understudied bacterium is naturally resistant to many antibiotics due to its unique structure, making it notoriously difficult to treat.
The WHO works to control the spread of gonorrhoea infections that are resistant to antibiotics through surveillance. My own research is adopting a similar strategy for M. genitalium, by using genomic surveillance to improve our knowledge of the infection and the improved ability to detect antibiotic resistance.
What is genomic surveillance?
Genomic surveillance uses next-generation sequencing technology to identify specific strains of pathogens circulating during an outbreak. This can also determine what genetic characteristics makes some strains more aggressive than others.
This technique was used effectively during the peak of the COVID-19 pandemic and helped identify variants quickly.
Genomic surveillance can help us understand what we are facing, allowing us to tackle emerging threats more quickly and efficiently. It can help us develop sensitive, rapid diagnostic tools to detect drug resistance, especially for bacteria that are difficult to study in the lab, such as Mycoplasma genitalium, which is an extremely slow-growing and challenging bacteria.
With the continuing emergence of untreatable infections and new disease outbreaks, genomic sequencing can help meet emerging threats even in regions that lack adequate infrastructure where these tend to occur frequently.
This can be achieved through implementing affordable, user friendly diagnostic tools or developing effective vaccines for endemic regions. An example is the COVID-19 self-test kit that can be used at home. This is one of the key areas my research is also trying to accomplish: improving diagnostics in health care and making them accessible.
Pathogens are constantly evolving to become resistant to treatment in the perpetual battle between humans and infectious diseases.
To get the upper hand, we need to continue developing technology, including rapid and sensitive tools for identifying resistant bacteria and innovative methods for halting the spread of untreatable infections before they become serious pandemics.
Idowu Olawoye, Postdoctoral Associate, Microbiology & Immunology, Western University
