In the spring of 1993, tragedy struck a Navajo family when their 19-year-old son, a marathon runner, suddenly collapsed with breathing difficulties and died shortly after arriving at a local hospital in New Mexico. His death, initially considered an isolated incident, soon revealed a pattern of unexplained respiratory illnesses affecting the Aboriginal community in the Four Corners region. Dr. Stephen Morse, a professor of epidemiology at Columbia University Irving Medical Center, highlighted the challenges in identifying the causes of mysterious disease outbreaks, citing the delay in recognizing the 1993 outbreak as hantavirus pulmonary syndrome. Fast forward to 2023, and China finds itself grappling with a surge of respiratory diseases, sparking concerns about the potential causes and implications. The National Health Commission of China reported a significant increase in respiratory illnesses, particularly among children, prompting extensive investigations. Unraveling the mystery behind such outbreaks poses a daunting challenge for researchers. Dr. Morse emphasized the critical role of advanced technologies like polymerase chain reaction (PCR) in identifying new pathogens, but also acknowledged the limitations of the technique. He stressed the importance of developing more advanced methods capable of detecting unknown pathogens without prior knowledge of their existence. Ultimately, the quest to solve mysterious disease outbreaks hinges on global collaboration, technological advancements, and a relentless pursuit of answers. Despite the myriad challenges and uncertainties, scientists remain committed to unraveling the secrets of these enigmatic diseases. By: [Author Name] Published in collaboration with “BBC News Chinese” One morning in the spring of 1993. A family from the Navajo Nation parked their car at a service station in New Mexico and called 911. Their son, a 19-year-old marathon runner, suddenly had trouble breathing. He was taken by ambulance to a local hospital where he died. The doctors looked puzzled – how could someone so young and healthy die so suddenly? It soon became clear that the marathon runner’s death was not an isolated incident. He organized the funeral for his fiancee, who died of a similar respiratory illness a few days earlier. Every time reports of new disease outbreaks hit the headlines, they were often accompanied by speculation. There are more virus particles on Earth than there are stars in the universe, and there are 10 times more bacterial cells in our bodies than mammalian cells. Overall, it is estimated that there are one trillion microbial species on our planet, but only 1,513 bacteria, 219 viruses, 300 parasites, 70 protozoa, and 200 fungi are currently known to cause human disease. The rest is waiting to be discovered. “Obviously there are cases that have been a mystery,” said Stephen Morse, a professor of epidemiology at Columbia University Irving Medical Center in New York City. In the case of the Navajo couple in 1993, local medical researchers noticed that others had experienced unexplained symptoms in the previous months. All of these cases occurred in the Four Corners Aboriginal community in the southwestern United States. As more cases come to light, the race begins to catch the “criminals.” It wasn’t until two months later that “hantavirus pulmonary syndrome” was identified as the culprit. This is an infectious disease caused by a new hantavirus that often infects rodents. Even today, such delays are very common. “There are still many infections that are undiagnosed acute respiratory distress syndrome and similar conditions, such as hantavirus pulmonary syndrome that were initially undiagnosed but later found through backtracking,” Morse said. To begin with, many disease outbreaks go unnoticed and unreported. Ultimately, Morse said, one specialist may have a particular interest in a particular infection, leading to an increase in reporting. “In other places, there are cases that go unnoticed because there are no technical facilities, because they are in remote areas, because there is no motivation.” As we all know, this happens with COVID-19. In December 2019, the World Health Organization received an alert about a cluster of pneumonia cases in Wuhan, China, but the cause was unknown. Within a month, Chinese authorities formalized the identity of the virus by sharing its genetic sequence with the rest of the world. However, some research suggests that the virus actually began circulating in humans as early as October 2019. Once a case is brought to people’s attention, the next step is actually to find the pathogen behind it. On November 13, 2023, the National Health Commission of China reported a surge in the number of respiratory diseases in the country, especially among children. More reports followed, describing overcrowded pediatric wards, hospitals overflowing with sick children and clusters of undiagnosed pneumonia. Chinese officials told the World Health Organization that they had not identified any new pathogens, but attributed the outbreak to a combination of respiratory syncytial virus (RSV) and regular winter illnesses such as influenza. Some neighboring countries, such as India, are cautious as to whether this is the full story, and WHO continues to monitor the situation. During the 1993 outbreak, researchers identified the virus that causes the infection using polymerase chain reaction (PCR), a cutting-edge technology at the time. Using specific DNA sequences from known hantaviruses, the scientists were able to find this previously undiscovered group of hantaviruses. Photo Credit: Getty Images / BBC News Outbreaks of hantavirus pulmonary syndrome, caused by the Sinnoble virus, are now linked to El Niño, a phenomenon that even leads to more rain and an increase in the number of rodents that carry the virus. “This is really the first time that molecular tests have been used to identify the pathogen (infection),” Morse said. Today, PCR has become a standard method for identifying pathogens, but it also has shortcomings. Because the technique requires sequences that are closely related to the pathogen you are looking for, it can be difficult to get answers without intuition about the possible causes of an outbreak. During the Four Corners outbreak, scientists had learned that those infected had antibodies to other hantaviruses, so they used this method. However, other, more advanced methods of searching for unknown pathogens are emerging that do not require specific information. A recently developed PCR method makes it possible to identify new pathogens in a wider group. Not only can you search for close relatives of known viruses, but you can also find other viruses in the same family. Another method is next-generation sequencing, which can help scientists discover microorganisms that are completely unknown to the scientific community. This technique was used to discover a new arenavirus in a study of a group of transplant patients who died after receiving an organ from the same donor. “In many laboratories in high-income or well-resourced countries, you can look at a sample and identify sequences that look like pathogen sequences, whether they’re viruses or bacteria … without having to know ahead hand what’s in it,” said Morse.” In 2010, an unknown bleeding disorder began to spread in northern Uganda. “I remember this personally because I was the co-director of Project Predict,” Morse said. He said there was a delay when investigators from the infection surveillance program arrived to take samples. But when they took samples, they found that some of the samples were positive for the yellow fever virus. “So it’s basically classified as a case of yellow fever, but there are infected people who have negative samples. So it’s probably yellow fever, but we don’t know for sure,” he said. Morse cited this as an example of many epidemics that remain mysteries to this day. So when an outbreak of a mysterious disease makes global headlines, in most cases scientists may already be able to figure out the cause behind it pretty well – but only in areas where they have the resources. This article is reprinted with the permission of “BBC News Chinese”. The original text is published here [Ymunwch fel aelod o Key Comment Network]Outstanding articles will be delivered straight to your inbox every day, and you’ll receive exclusive weekly editorial picks, current affairs picks, weekly art and other special e-newsletters. You can also leave a message to discuss the content of the article with the author, reporter or editor. Click now to become a free member! Editor in charge: Weng Shihang #Respiratory #disease #Chinese #children #unexplained #common #human #history #News #Lens #critical #comment #networkThe Challenge of Identifying Unknown Pathogens
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Reviewing editor: Ding Zhaojiu
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