Following the Covid-19 pandemic, the World Health Organization has strengthened and deepened scientific research into high-risk pathogens in the event of a future pandemic. The World Health Organization (WHO) special publication, “Prioritizing Pathogens: A Scientific Framework for Epidemic and Pandemic Preparedness Research,” specifies the pathogens, but also the global strategy for how to protect humanity from future threats. The WHO shifted its focus from crisis management to strategic prevention. This means that by studying a high-risk “prototype,” scientists build a shield for the entire group of pathogens.
GLOBAL HIGH RISK VIRUSES
The WHO has identified the viral families with the highest risk due to their lethal characteristics and lack of medical protection. The WHO singles out Lassa virus, noting that there is a “lack of medical countermeasures (MCM)” and that for Lujo virus, the mortality rate reaches “80% in the only known outbreak”. Lassa virus is a pathogen that causes Lassa Hemorrhagic Fever, an acute and often severe viral disease. This virus is classified by the World Health Organization (WHO) as one of the pathogens of high risk and with pandemic potential, due to the lack of licensed vaccines or specific treatments.
The disease was first discovered in 1969 in the town of Lassa in Nigeria, and is endemic and continues to spread in parts of West Africa. The natural reservoir of the virus is a specific type of West African rat. People become infected through direct contact with the urine, feces, or saliva of these rats. The “Lujo” virus of the same family is also a high risk because it spreads very easily from person to person.
Ebola
The WHO study notes that Ebola remains one of the most aggressive and feared pathogens in the history of modern medicine. In the new scientific framework of the World Health Organization (WHO), this virus is not treated as just a local African threat, but as a “prototype pathogen,” meaning that any discovery or failure about it determines the fate of dealing with similar unknown viruses (including “Unknown Pathogen X”). Ebola causes an acute and severe illness, which if untreated has a mortality rate that ranges from 50% to 90%, depending on the variant and the quality of health care.
The virus is not transmitted through the air (like the flu or Covid-19), but through direct contact with the bodily fluids of an infected or deceased person.
This makes it extremely dangerous for medical staff and family members. One of the most complex risks recently discovered is that the virus can “hide” in areas of the body that are protected by the immune system in people who have fully recovered. The latent virus can reactivate months or even years later, causing unexpected new outbreaks of the disease. Although the natural reservoir of the virus is fruit bats in sub-Saharan Africa, the risk to other regions such as Europe remains through rapid international travel.
Crimean-Congo Hemorrhagic Fever (CHF) Virus
The World Health Organization (WHO) raises the alarm about the Nairoviridae family. But what makes this group of viruses such a dangerous natural “biological weapon”? The main and most notorious representative of this family is the Crimean-Congo Hemorrhagic Fever Virus (CHF). After being bitten by an infected tick (of the genus Hyalomma) or coming into contact with the blood of infected cattle, the disease breaks out suddenly and aggressively. Within a few hours, the patient goes from a completely normal state to a very high fever (over 39°C-40°C) that does not easily subside. This phase lasts only 3 to 7 days, and is often confused with severe influenza or other tropical infections, which causes patients to lose precious time without isolating themselves and receiving proper care.
The virus attacks the cells that make blood clots. Their number drops to critical levels. The body undergoes complete collapse called hemorrhagic shock. Death usually occurs in the second week of the disease (between the 5th and 14th day) as a result of failure of all vital organs or massive blood loss. Mortality ranges from 5% to 40%. The virus poses a massive risk to doctors and nurses. If a bleeding patient is treated without high-level protective equipment, his body fluids infect the staff. This virus is not isolated only in Africa. It is called “Crimean-Congo” because it was first identified in Crimea (1944) and then in Congo (1969). It is already present in the Balkans.
NIPAH
Nipah virus is zoonotic (transmitted from animals to humans). Its natural reservoir is fruit-eating bats. Humans become infected by consuming fruit or juices (such as the sweet sap of Arabian date palms) that have been contaminated with the urine or saliva of infected bats. In the first major outbreak in Malaysia (1998), the virus jumped from bats to farm pigs and then to humans. In pigs, the virus causes a severe, highly contagious respiratory disease. In more recent outbreaks (in Bangladesh and India), the virus has shown a dangerous ability to be transmitted directly from one infected person to another.
What makes the Nipah virus clinically terrifying is its ability to simultaneously attack two of the body’s most vital systems, the respiratory system and the central nervous system.
Furthermore, the virus can remain “dormant” in the body and cause a fatal encephalitis months or even years after the initial infection. Meanwhile, there is no proven antiviral drug that eliminates the virus. The only treatment offered to patients in hospitals is supportive care. Because of this medical vacuum, the mortality rate is extremely high. In the geographical analysis of the WHO tables, the European Region (EUR) is marked with a cross (X) as an area directly exposed to some of the most aggressive pathogens.
CORONAVIRUSES
The WHO report highlights that Europe is at high risk of exposure to coronavirus subtypes that have already demonstrated global destructive potential. One of these is the “sarbecovirus,” a subtype that includes SARS-CoV that caused the 2003 outbreak and SARS-CoV-2 responsible for the Covid-19 pandemic. SARS-CoV emerged in 2002 in the Guangdong province of China. It caused the 2002–2004 SARS epidemic, with about 8,000 cases and a mortality rate of about 10%. It disappeared from human circulation after strict isolation measures. It reemerged in the form of SARS-CoV-2 in late 2019 in Wuhan, China, and caused the global COVID-19 pandemic.
Unlike its predecessor, this virus had a lower mortality rate per individual case, but an extremely greater ability to transmit, often asymptomatically, which led to millions of deaths globally due to the massive number of infections.
Merbecovirus is another subgenus that includes MERS-CoV, Middle East Respiratory Syndrome. Their main reservoir and source of direct transmission to humans are dromedary camels. It has a fairly high mortality rate (about 35%). Europe has large populations of bats and wild animals or intensive farms. WHO insists on monitoring them because these viruses undergo rapid mutations. If such a virus undergoes changes in the “Spike” protein, the part with which it binds to cells, it can regain the ability to infect humans massively.
H1N1
The WHO classifies Europe as a region at constant risk of both avian and human influenza with the H1N1 and H5Nx viruses, calling for preparedness for their mutations. H1N1 was responsible for the “Spanish Flu” of 1918 and the 2009 pandemic. It circulates regularly between humans and pigs, with a high ability to spread from person to person. Today, the H1N1 virus circulates as a common seasonal flu. Because the population has acquired immunity over the years (through past infections and vaccines), the mortality rate is quite low.
H5Nx, the bird flu, mainly affects wild and farmed birds. However, in recent years there has been an alarming increase in cases where the virus has spread to mammals (skunks, seals, cats and dairy cows) and occasionally to humans who have been in close contact with them. Europe has a highly developed poultry industry and is located on major migration routes for wild birds. If an H5Nx virus mutates or combines genes with a human flu virus, it could become a virus that is easily transmitted from person to person, leading to a pandemic with potentially high mortality.
WEST NILE VIRUS
This pathogen is transmitted mainly by common mosquitoes. The WHO reports that birds are the main hosts, while humans and horses are the human infectors. It can cause mild fever, but in severe cases it causes fatal encephalitis (brain infection). The Dengue and Zika pathogens are also transmitted by the Tiger mosquito, which is now present in most of Southern and Central Europe, including Albania.
- Dengue causes high fever and bone pain, while Zika is extremely dangerous for pregnant women because it causes microcephaly in the fetus. Tick-borne encephalitis, unlike others, is transmitted by tick bites in the forest areas of Central and Northern Europe, affecting the central nervous system.
MONKEY pox/MPOX
Following the declaration of global emergencies by the WHO in recent years, this virus has shown that it can spread beyond its traditional reservoir (rodents in Central and West Africa) through close human contact. Monkeypox (Mpox) is a viral disease caused by the Mpox virus, which belongs to the same family as smallpox, but Mpox is generally less severe and much less deadly. The name “monkeypox” has remained historical, as it was first discovered in 1958 in several laboratory monkeys in Denmark. However, monkeys are not the main reservoir of this virus; in nature it circulates mainly in small rodents (dormice, field mice and squirrels) in the tropical forests of Africa.
PATHOGENE X
In addition to the pathogens already known, scientists consider the spread of new, previously unknown viruses, dubbed “Pathogen X”, through climate change and global movement that makes the European region part of the front line of danger. Animals can be a source of new pathogens. 75% of new infectious diseases in humans originate from animals. There are an estimated 1.67 million undiscovered viruses in mammals and birds in nature. Huge farms with thousands of pigs or poultry serve as reservoirs of mutations. If a wild virus enters these farms, it can change at a frightening speed.
Due to global warming, the permafrost in Siberia and the Arctic is melting. There are frozen corpses of people and animals from past eras. Scientists have managed to awaken “zombie” viruses that have been frozen for 50 thousand years. The risk of an ancient virus, to which humanity has no immunity, returning to circulation is real. Laboratory accidents or bioterrorism are potential risks. The risk of an accidental leak from a high-security laboratory (BSL-4) or the deliberate modification of an existing virus remains part of the Pathogen X scenarios.