Disease X: Exploring the Unexplored, Knowable Unknown

Abstract

The glaring uncertainty regarding the identity of certain pathogenic bio-agents having potential for a severe global public health security threat has spurned the international health agencies to classify it as Disease X, which has been added to the "blueprint priority diseases" as a placeholder name for a "knowable unknown" pathogen by the WHO. The zoonotic diseases of viral origin and the synthetic viruses are acknowledged as the most likely agents of Disease X causing public health emergencies of international concern in times to come. The challenges in the rapid containment of Disease X pandemics could be the inability for early detection of the infectious agents, presence of a large immunologically naïve population, lack of knowledge of clinical spectrum, no pathogen-specific effective drugs and/ or vaccines and sudden surge of patients requiring hospitalisation which collectively compromise the public health system especially in resource stricken countries and leads to its eventual collapse. Well-equipped field laboratories, sentinel surveillance centres for viruses and other microbial pathogens are needed in strategically important and sensitive areas of concern for monitoring for early detection of possible bio-agents of Disease X, if any. In a changing geo-socio political scenario, use of the synthetic viruses as a potential bio-weapon for mass destruction and/ or for the economic breakdown of a targeted country should not be ruled out. Thus, capacity building, global technical collaboration and stringent international regulations to prevent the development of bioweapons are also obligatory to prevent any possible future pandemics of Disease X.