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Five overlooked steps to identify new epidemics, fast
Serge Tonen-Wolyec is a coordinator at the Interdisciplinary Center for Translational Research in Medicine and Health Sciences, Bunia, the Democratic Republic of the Congo, and professor of infectious diseases in the Faculty of Medicine, University of Bunia.
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Laurent Belec is a virologist in the Faculty of Medicine, Paris Cité University, Paris, France, and in the Department of Microbiology, Assistance Publique-Hôpitaux de Paris, Paris.
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Identifying people who have an infection and keeping them isolated can be key to managing emerging diseases. Credit: Lisa Maree Williams/Getty
The current deadly outbreak of Ebola in Africa is the latest in a string of diseases to grab headlines in recent years — from COVID-19 to mpox and hantavirus. Outbreaks are easier to control if they can be detected early and contained. But many emerging, evolving or unfamiliar diseases fall through the cracks of current surveillance systems.
Better diagnostics could have limited this Ebola outbreak
Epidemics are tracked using three approaches. First, event-based tracking monitors local information sources — media reports, social-media posts, community alerts and health-worker reports — to detect early signals of an outbreak. Second, genomic sequencing is used to confirm a pathogen’s identity1,2. And third, syndromic surveillance looks for people at risk of being infected, by identifying and monitoring individuals who present with characteristic symptoms.
But these strategies don’t account for the fact that an emerging pathogen might present with unusual or atypical symptoms. The presentation of symptoms can change over time, as a pathogen evolves3, and they can also vary between people, who might have different levels of immunity. And co-infections that present with similar symptoms to those caused by a pathogen can obscure diagnoses4.
This gap in surveillance has caused problems time and again.