For a long time, the absence of specific guidelines on how to name new diseases has been the root cause of controversial names.
How to name a new disease in the past
Let’s look back at 2009, the year that marks the outbreak of the new strain of influenza, H1N1. The virus is also known as swine flu because the first person infected with the disease has had previous contact with pigs. “It is because of this name that many people are afraid to eat pork and pork consumption has decreased globally. Egypt even ordered the slaughter of all pigs in the country to avoid the spread of the disease. This is, in fact, not necessary because it is a respiratory illness, transmitted from infected persons to healthy persons through sneeze and cough droplets”, said Kazuaki Miyagishima, Director of the Department of Food Safety and Zoonoses at WHO.
Besides, naming a disease after people, places or occupations also has equally serious consequences. Would anyone want to go swimming on the Ebola River (whose name has been used to name a virus that causes haemorrhagic fever) or buy a cottage in the town of Lyme (whose name has been used to name an infection caused by Borrelia bacteria)? Would you avoid contact with veterans for fear of contracting Legionnaires’ disease (Legionnaires is originated from Legion in English)?
How do we name new diseases today?
In the past, people used inappropriate names to name diseases. For example, the name of Malaria disease, first named in the 1890s, is originated from the Italian word for “dirty air”, although it is now well known that the virus that causes the disease is not transmitted through the air. Or Rabies disease, named very early in the 16th century, comes from Latin, which refers to
”madness” or “foolishness”. Although advanced rabies can also cause people to behave abnormally or become delirious, the name does not say much about the pathogen nor the way the virus spreads.
Today, newly emerging diseases have been named more accurately, but sometimes still controversially. Naming new diseases after places makes people living in those places feel frustrated because they have to share the same name with an epidemic, such as Hendra disease which is a virus-caused respiratory and neurological disease in humans and horses that can be fatal, was first discovered in Hendra, a suburb of Brisbane, Australia.
Or in the case of AIDS, which was first discovered in 1982 and was originally named “gay-related immunodeficiency disease” because the first group of victims of the disease were all gay men. But due to the fact that the disease affected both men and women who have heterosexual relationships with infected people, especially injecting drug users, in the same year, the US Center for Disease Control and Prevention (CDC) officially used the term AIDS to describe the true nature of the disease.
Authority to decide on an official name for a new disease
While the International Commission on Taxonomy of Viruses is the one vested with the power to decide on the official name of a new disease, however, common name is often spread by the media at breakneck speed, so it is unlikely to change, which is exactly the case with “swine flu”. Miyagashima further said, “once the wrong/inappropriate name has been established, it is very difficult to change. So the best option is to make sure that the person who names the new disease — whether it’s a scientist or a journalist — follows the same code of best practice so that an appropriate name can be given in the first place.”
In this effort, and with the motto that disease names should ensure the balance between two factors, namely providing useful information, and not having pejorative connotations. In 2015, the World Health Organization (WHO) issued a code of best practice for naming new diseases in humans, to avoid names that convey misleading information or may lead to discrimination against a specific community. The WHO encourages researchers, scientists and doctors (or anyone who may be tasked with naming a newly identified disease) to avoid names of places, people, animal species and phrases that “give rise to undue fear”, such as “unknown”, or “fatal”.
Specifically, the guidelines recommend that disease names should include:
- General descriptive terminology for clinical symptoms, physiological processes, affected organs: fever/insufficiency/inflammation/infection; hepatic/intestinal/nervous/gastrointestinal etc.
- Descriptive terminology for: age group (child/adolescent/adult/elderly), origin (zoonotic, etc.), duration of illness (acute/subacute/chronic/transient), severity (severe/moderate/mild), season (winter/summer/seasonal), environment (sea/ocean/desert/river/lake)
- Terminology for pathogens: viruses/bacteria/parasites, new/variants, subtypes, serogroups
- The year when the disease was first discovered or reported
While the above guidance is unlikely to be followed absolutely, we can at least ease the fear of one day there is a sudden epidemic caused by the virus named after [OUR SURNAME].
Naming controversy for Covid-19 Acute Respiratory Distress Syndrome
Just weeks after its discovery, it was given all sorts of impressive names, such as “Wuhan flu,” “Wuhan coronavirus,” “coronavirus,” “nCoV-2019,” and even former U.S. president Donald Trump called it “Chinese Virus.”
On 11 February, the WHO announced the official name of the disease caused by the novel coronavirus as “Covid-19” (short for “coronavirus diseases 2019”).
But before the announcement session ended, the International Committee on Taxonomy of Viruses published an article in which it proposed naming the disease based on the nature of the virus that causes the disease: “severe acute respiratory syndrome coronavirus 2”, abbreviated as Sars-CoV-2.
The name reflects research showing that the new virus that is raging is closely related to the virus that causes Sars.
Curiously, a WHO spokesperson told the Science journal that they would not use the name out of concern that the word “Sars” would cause more panic.
So, even with guidelines available, naming of a disease is still a controversial issue as a result of the lack of common voice among regulatory authorities.