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<ul class="summary-list"><li>A dangerous type of <keyword id="14446988" type="UNKNOWN" weightage="60" keywordseo="parechovirus" source="Orion">parechovirus</keyword> is circulating in the US, infecting newborns.</li><li>At least one baby died in Connecticut, and the CDC has tracked the virus in "multiple states."</li></ul><p>When baby Ronan was born on May 21 this year, he was a "healthy, full-term," 8 pound-5 ounce boy.</p><p>But about 10 days after Ronan was born, his mother, Kat DeLancy, started noticing some redness on his face. Perhaps he'd been in the sun too long. </p><p>He had no fever, and "seemed otherwise perfectly fine," DeLancy told Insider. </p><p>Just a couple days later, Ronan was irate.</p><p>"Crying and crying and crying," she said.</p><p>His chest turned bright red, he stopped eating much of anything, and seemed sleepy and low-energy.</p><p>Doctors suspected it could be colic, but "I just had a bad feeling," DeLancy said. "He didn't look good to me." </p><p>In the middle of the night, the worried mom rushed her newborn to the hospital. There, a provider noticed he looked pale. Clinicians stuck an oxygen saturation monitor on his foot, then on his tiny toe. The reading, which should register around 95% in a healthy person, first read 70%, then 20%. </p><p>Immediately, the infant was whisked away and intubated. Practitioners found out Ronan had been having seizures. Brain scans revealed some damage, possibly repairable. But it took about four days of tests to really figure out what was wrong. Ronan <a href="https://www.insider.com/cdc-issues-alert-parechovirus-sickening-killing-young-infants-in-us-2022-7">had a parechovirus</a>.  </p><p>"No one seemed to believe that he had a virus," DeLancy said. Perhaps it was a genetic condition, some doctors speculated. "One <keyword id="12198136" type="UNKNOWN" weightage="60" keywordseo="infectious-disease" source="Orion">infectious disease</keyword> doctor actually said that they thought it might be head trauma. They were asking me questions like, had I ever dropped my baby? Had anybody else held my baby?"</p><p>Initially, DeLancy was assured that her baby would fully recover from the viral illness. After all, most babies and toddlers get this virus at some point. But that's not what happened to Ronan. </p><h2>Most kids get a parechovirus infection at some point, and many never know it</h2><div type="image" title="picture of ronan with eyes open, one day old, swaddled in hospital crib" height="451" width="600" msid="92923477" hostid="261" sizebytes="14970"></div><p>Parechovirus are part of a large family of viruses (<em>Picornaviridae</em>) that cause a wide array of viral illnesses ranging from the simple, common cold (rhinovirus) to crippling polio. </p><p>Most children will get some kind of <a href="https://www.insider.com/cdc-issues-alert-parechovirus-sickening-killing-young-infants-in-us-2022-7">parechovirus before they start grade school</a>. Usually, the illness clears up on its own in about seven days. It is rarely tested for, unless a patient is severely ill. </p><p>"We'll say, 'Oh, this is probably a parecho or a coxsackievirus,'" Dr. Andrew Wong, a primary care physician with Hartford Healthcare, said. "We'll give them Tylenol, hydration, Advil, and they'll get better in a week."</p><p>But infectious disease doctors nationwide are growing increasingly worried about one particular type of parechovirus called PeV-A3, which is associated with severe disease in very young infants.</p><p>The Centers for Disease Control and Prevention put out a special <a href="https://emergency.cdc.gov/han/2022/han00469.asp?ACSTrackingID=USCDC_511-DM85721&amp;ACSTrackingLabel=HAN%20469%20-%20General%20Public&amp;deliveryName=USCDC_511-DM85721">alert</a> to healthcare providers nationwide Tuesday, <a href="https://www.insider.com/cdc-issues-alert-parechovirus-sickening-killing-young-infants-in-us-2022-7">urging them to test for parechovirus in children</a> who have unexplained fevers, seizures, loss of appetite, irritability, rashes, and sleepiness.</p><h2>'Hot, red, angry babies' </h2><div type="image" title="sleeping baby ronan" height="719" width="959" msid="92923479" hostid="261" sizebytes="83992"></div><p>Dr. Claire Bocchini, an infectious disease specialist at Texas Children's Hospital who has treated babies that are critically ill with parechovirus, says with A3, one of the most "classic" symptoms of severe illness can be seizures, a tell-tale sign that the virus has invaded the brain.<strong><br /></strong></p><p>"You can have babies who are very, very fussy, irritable, then become very sleepy, aren't eating well," she said.</p><p>They may have sepsis, with the virus impeding the baby's heart and liver function. Eventually, parechovirus A3 can kill or seriously brain damage newborns.</p><p>Other children never show outward symptoms of the infection and develop normally. Most of the high risk cases happen in babies, like Ronan, who are less than one month old. But even a six month-old can be susceptible to a bad case of parechovirus.</p><p>In <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5740974/">2017, pediatricians and infectious disease experts in New Zealand wrote a paper</a> in a prominent microbiology journal, acknowledging that parechovirus "is increasingly being recognized as a potentially severe viral infection" in babies.</p><p>"In young infants, the typical clinical presentation includes fever, severe irritability, and rash, often leading to descriptions of 'hot, red, angry babies,'" they said. </p><p>Ronan never logged a fever, and his mother believes that was a big part of the reason it took providers so long to figure out what was going on.</p><p> "It took a lot of pushing and prodding and tests for them to find it in my son," she said. "And honestly, I don't think that they would've kept testing if I didn't keep just being annoying."</p><p>While there is no treatment for parechovirus, there are <a href="https://www.uptodate.com/contents/intravenous-immune-globulin-ivig-beyond-the-basics">immune-boosting therapies</a> often given to the most severe patients, including Ronan. Sometimes they work, and sometimes they don't. </p><p>Ronan didn't get better. The longer his infection wore on, the worse his brain damage became.</p><p>Scans showed to his mom near the end of his life showed "areas where there was actually no tissue anymore," she said. "They said his entire frontal lobe is basically gone. His entire parietal lobe is almost entirely gone."</p><p>There wasn't much left to do for the boy, who died at 34 days old. </p><div type="image" title="baby ronan in the hospital intubated lying, sleeping" height="360" width="480" msid="92923482" hostid="261" sizebytes="18280"></div><h2>Handwashing and avoiding kissing or sharing drinks is critical</h2><p>Bocchini is careful not to blame parents when their kids get severely sick with parechovirus. </p><p>"I always tell parents that there's nothing that they can do to really prevent these infections when they happen," she said. Newborn immune systems, still developing, are highly susceptible to all kinds of viral problems.</p><p>Still, because people can shed parechovirus in their stool for up to six months after an infection, thorough handwashing is a critical piece of prevention.</p><p>"Soap and water for 20 seconds," Bocchini said. "After you go to the bathroom, after you change a diaper, before you eat, before you feed an infant, that's always important." </p><p>Because there isn't good surveillance or testing for this virus, it's unclear how common deadly infections like Ronan's really are. One <a href="https://academic.oup.com/cid/article/50/3/357/394251?login=false">2010 autopsy study from Wisconsin</a> showed a parechovirus present in at least 18 dead children in that state over a 17-year span, but it's unclear whether those viruses are what actually caused the infant deaths. </p><p>DeLancy, Wong, and Bocchini are all hopeful that more awareness and testing for the virus now will help providers get a better sense of the scope of the problem. That could lead to future antiviral treatments for the illness, rapid tests, or, one day, a vaccine for pregnant mothers. </p><p>"It's a very long term goal," DeLancy said, but she hopes in a decade or so, "they'll be able to give them a medication or <a href="https://researchforronan.com/">something to treat it</a> before it escalates to needing to go to the hospital."</p>

A healthy baby died at 1 month old after contracting a severe version of a common virus. It's now showing up in multiple states.

<ul class="summary-list"><li>The CDC is warning that <keyword id="14446988" type="UNKNOWN" weightage="60" keywordseo="parechovirus" source="Orion">parechovirus</keyword> are spreading in "multiple states."</li><li>While older kids typically suffer mild respiratory infections, the viruses can be life-threatening for babies.</li></ul><p>Federal <keyword id="11894571" type="UNKNOWN" weightage="100" keywordseo="health" source="Orion">health</keyword> officials in the US are warning doctors and parents that a dangerous virus is spreading across the US causing fevers, seizures, confusion and other "sepsis-like" issues that can be life-threatening for young infants.</p><p>The <a href="https://emergency.cdc.gov/han/2022/han00469.asp">Centers for Disease Control and Prevention (CDC) said Tuesday</a> that parechovirus is currently circulating in "multiple" US states. So far, the CDC has only collected positive samples of PeV-A3, which is the specific type of parechovirus that is most often associated with severe disease. At least one newborn is dead in Connecticut. </p><p>Baby Ronan was less than two weeks old when his mom starting noticing he was becoming "very angry," and "crying a lot," <a href="https://www.wtnh.com/on-air/connecticut-families/research-for-ronan-hamden-family-shares-devastating-loss-of-baby-to-raise-awareness-of-parechovirus/">WTNH New Haven reported</a>. </p><p>His chest turned red, and then his face too, and at 14 days old he was admitted to the hospital, where he <a href="https://www.wfsb.com/2022/07/02/hamden-family-is-heartbroken-after-their-one-month-old-baby-died-suddenly-rare-virus/">started having seizures</a>. At 34 days old, the <a href="https://researchforronan.com/">child died</a>. </p><p>There is no known treatment for parechovirus. Older children who get infected may "only have mild illness," like a cold, while others may remain <a href="https://www.childrens.health.qld.gov.au/fact-sheet-parechovirus/">completely asymptomatic</a> during their infection, and feel nothing at all, the <a href="https://www.cdc.gov/non-polio-enterovirus/index.html">CDC says</a>.</p><h2>CDC is telling doctors to be alert for signs of parechovirus</h2><p>The CDC is urging pediatricians across the US to consider that parechovirus may be the culprit when very young patients present with unexplained:</p><ul><li>fever</li><li><a href="https://www.cdc.gov/sepsis/what-is-sepsis.html">sepsis-like syndrome</a></li><li>seizures</li><li>or <a href="https://www.cdc.gov/meningitis/viral.html">meningitis</a> (common symptoms include: high fever, irritability, loss of appetite, and sleepiness)</li></ul><p>The federal health agency is urging doctors to test for PeV in infants who may have such signs and symptoms "without another known cause."</p><p>US surveillance for parechovirus is spotty: the CDC typically logs <a href="https://www.cdc.gov/mmwr/volumes/67/wr/mm6718a2.htm">fewer than 50 parechovirus cases across the country</a> every year.</p><p>In toddlers under 5, common symptoms can include an upper respiratory tract infection, fever, and rash. Most "children are infected by the time they start kindergarten," the CDC says. </p><p>Illnesses in toddlers and older kids are typically mild, but <a href="https://www.cureus.com/articles/103341-novel-presentation-of-parechovirus-encephalitis-in-children-two-unique-cases">there are at least a few reports of children as old as 8 </a>weathering severe infections of parechovirus, with fevers, rash, blurred vision, trouble walking, headaches, and confusion/altered mental status.</p><p>Parechovirus are generally most dangerous for babies younger than 3 months old, especially newborns who are younger than one month old, like Ronan was. Spinal fluid which is taken from infants who have a parechovirus often has few to no infection-fighting white blood cells in it. </p><p>"It's important in the first months of life to keep your baby away from anyone who is sick," Dr. Thomas Murray from Yale-New Haven Children's Hospital told WNTH.</p><p><em>Correction: An earlier version of this story misstated when Ronan was admitted to the hospital. He was 14 days old. </em></p>

CDC: US infants are falling sick with a life-threatening virus that triggers fever, delirium, seizures, and sepsis

<ul class="summary-list"><li>A troubling number of parechovirus cases have been diagnosed in newborns across the US this year, including one "unusually large" cluster of 23 cases in Tennessee.</li><li>While life-threatening cases are rare, at least one baby has died. Others have had persistent seizures that may cause brain damage.</li></ul><p>Doctors at the Centers for Disease Control and Prevention say an unusually high number of dangerous viral infections have been diagnosed among newborns across the US this year, including one "unusually large cluster" of nearly two dozen cases at a single hospital in Tennessee.</p><p>The infections — which are caused by a common parechovirus — can trigger a range of troubling <a href="https://www.insider.com/cdc-issues-alert-parechovirus-sickening-killing-young-infants-in-us-2022-7">symptoms</a> in babies including fever, fussiness, poor feeding, and strange rashes.</p><p>While <a href="https://www.insider.com/healthy-newborn-died-parechovirus-signs-symptoms-2022-7">life-threatening</a> cases are still rare, at least <a href="https://www.insider.com/cdc-issues-alert-parechovirus-sickening-killing-young-infants-in-us-2022-7">one newborn child has died from the virus this year</a>, and others have suffered debilitating consequences.</p><p>Federal health officials suspect that the uptick in severe cases "might reflect relaxation of COVID-19 isolation measures," and the fact that more diseases of all kinds are traveling around from person to person now. </p><p>In a <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7130a5.htm?s_cid=mm7130a5_w">new report released on Thursday</a>, CDC clinicians detailed how at one children's hospital in Tennessee, 23 "previously healthy infants" ranging in age from just five days to three months old were diagnosed with parechovirus infections during a six week period from mid-April to the end of May. </p><p>The most common symptoms those children shared included:</p><ul><li>Fevers (20/23 babies)</li><li>Fussiness (13/23 babies)</li><li>Poor feeding (8/23 babies)</li></ul><p>The cluster of cases is especially concerning because while parechovirus infections are common in young kids, typically that number of cases would be logged over a period of several months at this hospital, not weeks.</p><p>Earlier in July, the CDC warned clinicians nationwide that <a href="https://www.insider.com/cdc-issues-alert-parechovirus-sickening-killing-young-infants-in-us-2022-7">a dangerous form of parechovirus, PeV-A3</a>, is circulating in "multiple states." Disease experts are recommending doctors test any babies who may present with fevers, sepsis-like syndrome, seizures, or meningitis, "without another known cause."</p><h2>The virus can prompt hearing loss and 'severe' brain damage</h2><p>Of the 23 patients in this study, 21 recovered from their viral infections without any known complications. But one baby had possible hearing loss and blood clotting issues, while another went through "persistent seizures" and clinicians expect that child will have "severe" developmental delays. </p><p>Most children will <a href="https://www.insider.com/cdc-issues-alert-parechovirus-sickening-killing-young-infants-in-us-2022-7">contract some form of parechovirus</a> by the time they enter kindergarten, but the viral illness can be especially dangerous for the very littlest babies who get it (those under 3 months old). In <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5740974/">2017, pediatricians and infectious disease experts in New Zealand</a> said parechovirus "is increasingly being recognized as a potentially severe viral infection" in babies. </p><p>"I always tell parents that there's nothing that they can do to really prevent these infections when they happen," Dr. Claire Bocchini, a pediatric infectious disease specialist at Texas Children's Hospital, previously <a href="https://www.insider.com/healthy-newborn-died-parechovirus-signs-symptoms-2022-7">told Insider</a>.</p><p>Bocchini says parechovirus type A3 can prompt severe infections in babies' brains, leading to seizures and brain damage.</p><p>She recommends parents and caregivers practice "very good handwashing," especially after going to the bathroom and changing diapers, and keep newborn infants away from sick people as much as possible.</p><p>"Babies, unfortunately, are at risk of severe outcomes for multiple viruses," she said. "But this is certainly a scary one."</p>

CDC: 'Unusually large' number of newborns infected with potentially life-threatening virus that can trigger fever, poor feeding, and seizures

<ul class="summary-list"><li>Doctors working in ERs, ICUs, and urgent care clinics across the US are seeing a spike in RSV cases.</li><li>Some infants and toddlers have needed help breathing and clearing out mucus to survive the illness.</li></ul><p>There is one illness taking up more pediatric beds in ERs and ICUs than any other right now. It may feel like just a typical cough or cold for many adults and older kids, but for newborns, young toddlers, and elderly people, it can be very dangerous.</p><p>It's called respiratory syncytial virus, or RSV for short, and this year it's shown up earlier than usual.</p><p>Emergency doctors from Texas, California, Washington, Utah and Maryland told Insider they fear the RSV surge they're seeing now may be just the beginning of a monthslong wave of nasty viral winter illnesses in kids. </p><p>There's been chatter in the media about a "<a href="https://www.nytimes.com/2022/10/23/health/flu-covid-risk.html">tripledemic</a>" on the horizon — an incoming storm of RSV, influenza, and COVID. For now, RSV is leading the way.</p><p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6768705/">RSV hospitalization</a> rates for small children are worse than for flu or for COVID.  In some of the <a href="https://emergency.cdc.gov/han/2021/han00443.asp">worst cases</a>, children are having trouble breathing on their own, needing oxygen and mucus-suctioning to clear their airways.</p><p>"It's kind of like a roller-coaster ride — we feel like we're climbing up the big steep hill now and expect to continue to see increasing RSV activity," Dr. Per Gesteland, a pediatric hospitalist at the University of Utah Health and Intermountain Primary Children's Hospital, told Insider.</p><h2>The beginning of a big wave</h2><div type="image" title="RSV graph showing cases climbing" height="626" width="831" msid="95152449" hostid="261"></div><p>Dr. Christina Johns, an emergency physician at PM Pediatric Care in the Washington, DC suburbs, told Insider that doctors know how to treat kids with RSV and deal with surges, which happen yearly. The "hard part" is that this year's RSV spike has come early and amidst a wave of other illnesses, including flu.</p><p>Additionally, this surge comes on the back of summer spikes in enterovirus, <a href="https://www.insider.com/rsv-respiratory-syncytial-virus-children-hospital-symptoms-signs-risk-prevent-2022-10">RSV</a>, and <a href="https://www.insider.com/healthy-newborn-died-parechovirus-signs-symptoms-2022-7">parechovirus</a>. Hospitals are already short staffed, with fewer pediatric beds available. </p><p>"It's wild," she said. </p><p>Between 2008 and 2018, the number of inpatient pediatric units decreased by almost 20%, according to a January 2020 study in the journal <a href="https://publications.aap.org/pediatrics/article/148/1/e2020041723/179950/Availability-of-Pediatric-Inpatient-Services-in?autologincheck=redirected?nfToken=00000000-0000-0000-0000-000000000000">Pediatrics</a>. During the pandemic, the shortage has only gotten <a href="https://www.nytimes.com/2022/10/11/health/pediatric-closures-hospitals.html">worse</a>. </p><p>It's tough to be precise about how rampant RSV spread is right now, because most cases can be managed at home without a test. Even in the hospital, not everyone who's sick gets tested.</p><p>Dr. Melanie Kitagawa, medical director of the pediatric intensive care unit at Texas Children's Hospital, told Insider more than 40 kids there are hospitalized with RSV, and more than 10 of them are in her ICU.</p><p>"I don't have a medication that can take this virus away," Kitagawa said. "I just have to help the kids through, and give their bodies time to fight."</p><div type="image" title="nurse in mask caring for baby in ICU" height="1115" width="1486" msid="95152452" hostid="261"></div><p>Dr. Behnoosh Afghani, a pediatric infectious disease specialist at <a href="https://www.ucihealth.org/find-a-doctor/a/behnoosh-afghani">UCI Health</a> in Orange County, California, said the number of RSV patients in her hospital is also increasing "rapidly" this week. </p><p>Gesteland helped develop a "<a href="https://intermountainhealthcare.org/health-information/germwatch/">GermWatch</a>" illness forecasting system at his hospital in Utah, and while RSV activity is "moderate" for now, he expects the illness will be "filling up our beds pretty significantly in the coming weeks." </p><p>During an October 23 weekend shift, Johns said about half of the kids she saw had flu-like illnesses. Among them, roughly 30% tested positive for RSV, and 25% for the flu. </p><p>Across the country at Seattle Children's, it's a similar story: nearly a third of the tests done for viral illnesses are coming back positive for RSV. </p><p>"We are seeing about 20 to 30 positives per day," Dr. Russell Migita, a clinical leader of Emergency Services at Seattle Children's, told Insider. That's double what's normal for October in the Pacific Northwest, where RSV typically peaks in February and March. </p><p>Cases this year are both earlier and more severe, exacerbating the status of Migita's already overburdened ER, which he says is routinely running at 200% capacity. ER patients are constantly "waiting for inpatient beds," and more than half are there due to respiratory illnesses. Migita, like the other doctors interviewed for this story, expects the number of RSV cases is only "likely to go higher" in the coming months.</p><h2>'Don't kiss the baby' — or the toddler</h2><div type="image" title="baby with tubes in, doctor using machine" height="600" width="1200" msid="95152454" hostid="261"></div><p>RSV is typically a milder illness for toddlers and school-age kids, hitting only newborns hard. But Dr. Kurt Lucas, an emergency medicine physician working in the Houston metro area, has noticed a troubling trend of 3 and 4 year-old kids getting very sick with RSV this year. Johns and Gesteland have seen the same thing.</p><p>Migita said that typically "children get many viral infections spread out over their first two years of life," but now those illnesses are all being "clustered" as COVID restrictions relax and more toddlers re-emerge into school and daycare.</p><p>"They're having a pretty significant infection with a viral pneumonia, needing oxygen, needing support," Gesteland said. "It seems like it's the first time they've seen RSV."</p><p>There is no vaccine for RSV, though there is one for pregnant women in late-stage clinical trials, as well as another for elderly patients in development. High-risk infants can receive a <a href="https://www.cdc.gov/rsv/clinical/index.html#:~:text=It%20is%20given%20in%20monthly%20intramuscular%20injections%20during%20the%20RSV%20season%2C%20which%20generally%20occurs%20during%20fall%2C%20winter%2C%20and%20spring%20in%20most%20locations%20in%20the%20United%20States.">monoclonal antibody</a> treatment developed for RSV, but it's expensive and requires monthly injections during flu season. </p><p>"Just be careful about exposure to other people with colds," Afghani cautioned. What may be a sniffly nuisance RSV infection for a healthy mom, dad, or older sibling, could be a serious illness for a newborn. </p><p>"Don't kiss the baby," Johns said. "If there ever was a time not to do it, it's now."</p>

Doctors say RSV is hitting toddlers hard this year as sick kids line up for hospital beds across the US

<ul class="summary-list"><li>Polio, monkeypox, marburg virus, and other infectious diseases are surging around the globe.</li><li>Experts say there's not one thing driving the surge — a multi-layered perfect storm has been brewing for some time.</li></ul><p>2022 has been a banner year for global infectious disease spread — and it's not just COVID.  </p><p>First, there were the reports of little kids with <a href="https://www.businessinsider.com/cdc-5-dead-109-ill-pediatric-hepatitis-outbreak-2022-5">mysterious and life-threatening liver failure</a> across the US and Europe. Then <a href="https://www.insider.com/monkeypox-gay-bisexual-men-affected-but-who-warns-stigma-2022-5">monkeypox</a> cases <a href="https://www.cdc.gov/poxvirus/monkeypox/response/2022/us-map.html">surged</a> across the globe like never before.</p><p><a href="https://www.insider.com/meningococcal-disease-meningitis-outbreak-florida-2022-6">Meningitis</a> has killed at least a dozen people in Florida this year, according to state epidemiologists, while a fatal <a href="https://www.insider.com/healthy-newborn-died-parechovirus-signs-symptoms-2022-7">parechovirus infected newborns</a> across several states — at least one baby died in Connecticut. In Australia and Belgium, <a href="https://theconversation.com/diphtheria-is-back-in-australia-heres-why-and-how-vaccines-can-prevent-its-spread-186348">diphtheria made a comeback</a>, and cases of the <a href="https://www.cdc.gov/vhf/marburg/outbreaks/chronology.html">Marburg virus</a> are being identified for the first time ever in Ghana.</p><p>Then, just last week, New York City announced that there is <a href="https://www.health.ny.gov/diseases/communicable/polio/wastewater.htm">polio in its wastewater</a>, mirroring a highly unusual trend picked up in <a href="https://www.insider.com/polio-found-in-london-sewage-water-uk-health-officials-investigating-2022-6">London's sewers</a> in the spring. </p><p>"It's like all the biblical plagues are coming back, right?" Dr. Madhukar Pai, a global health expert at McGill, told Insider. </p><p>It didn't happen overnight, and it's not a direct result of the pandemic either, but disease experts agree: the <a href="https://affiliate.insider.com?u=https%3A%2F%2Fwww.nature.com%2Farticles%2Fs41579-021-00639-z">pace of these infectious outbreaks</a> is <a href="https://www.cfr.org/timeline/major-epidemics-modern-era">quickening</a>. </p><p>Pai and other top-tier experts say there is no single, "simplistic" explanation. Instead, there is a wide web of at least seven powerful, interwoven issues undergirding the trend. </p><p>"It's definitely not something that we hoped would happen in public health, but it's also a situation which we feared might happen," Dr. Jay Varma, an expert in disease control and prevention at Cornell, said. "If you think about it almost like a sports event, the offense has gotten more intense — if you consider the viruses and pathogens that are out there — and our defense has weakened at the same time."</p><p>Here are the top seven factors driving disease outbreaks in 2022.</p><h2>ONE: Humans and animals have more close contact</h2><div type="image" title="mink covid-19" height="1848" width="2464" msid="93614982" hostid="261"></div><p>As climate change pushes people and animals out of their homes, <a href="https://www.businessinsider.com/heres-how-the-us-handled-its-first-ever-monkeypox-outbreak-2022-5">pets</a> and animal products travel the globe, and worldwide demand for meat reaches <a href="https://www.globenewswire.com/news-release/2021/03/22/2197061/0/en/Global-Animal-Protein-Market-to-Reach-58-50-Billion-by-2027-AMR.html">all-time highs</a>, we're collectively coming in contact with all kinds of animals far more often than we used to.</p><p>"The human-animal interface has been broken," as Dr. Larry Brilliant, who helped eradicate smallpox, <a href="https://www.youtube.com/watch?v=RyFcfL6iF4o&amp;t=872s">recently put it</a>. </p><p>The <a href="http://www.emro.who.int/fr/about-who/rc61/zoonotic-diseases.html">World Health Organization</a> estimated in 2014 that 75% of today's emerging pathogens have "originated in animals," a number that has been accelerating in recent decades. </p><p>Human-animal interaction is how <a href="https://www.science.org/doi/10.1126/science.abp8715">COVID</a> first spread into people. Ebola, HIV, MERS, SARS, <a href="https://www.businessinsider.com/pandemic-flu-comes-from-birds-first-2019-7">influenza</a>, and monkeypox all have animal reservoirs, too. When a disease pivots from animals into people, it always has the potential to spawn a new outbreak. </p><p>"The first factor that's driving transmission is increasing interaction between humans and animals, in <a href="https://thehill.com/opinion/energy-environment/583117-why-stopping-deforestation-must-be-a-priority-for-public-health/amp/">settings that are not entirely natural</a>, or settings that are different from the way they have been in the past," Varma said.</p><p>Deforestation, sequestration of livestock, and <a href="https://www.worldwildlife.org/initiatives/reducing-zoonotic-disease-risk-from-wildlife-trade">illicit wildlife trade</a> — they all play a role.</p><p>"Human population is now so enormous that we will infiltrate into all sorts of ecosystems where we will encounter novel organisms — organisms to which we don't have much prior immunity," Pai added. </p><h2>TWO: The pace of global travel and migration</h2><div type="image" title="flight attendant riding moving walkway at aiport with suitcase" height="3000" width="3999" msid="93614985" hostid="261"></div><p>The global, interconnected, social nature of modern life helps spread diseases between people more efficiently than ever. Any infectious disease anywhere in the world is just one flight away. </p><p>"Every time someone gets on a plane, there is some very tiny risk that they'll be carrying something new with them," Dr. Eric Rubin, editor in chief of the New England Journal of Medicine, told Insider. "The more people get on planes, the more that risk goes up."</p><p>It's a <a href="https://www.businessinsider.com/emirates-plane-flu-harvard-doctor-says-were-lucky-it-wasnt-mers-2018-9">numbers game</a>. And with the number of air <a href="https://www.transportation.gov/briefing-room/air-travel-consumer-report-consumer-complaints-against-airlines-rise-more-300-percent">travelers now skyrocketing</a>, new pathogens can travel very fast, and very far.</p><p>In 2022, both monkeypox and polio hitched a ride on planes, infecting people on new continents. Conversely, when global travel ground to a halt in 2020, the <a href="https://www.businessinsider.com/two-flu-varieties-disappeared-lockdown-extinct-2021-6">flu essentially disappeared for a year</a>.</p><h2>THREE: The worsening climate crisis</h2><div type="image" title="A photo of an insurance adjuster inspecting flood damage." height="600" width="1200" msid="93614987" hostid="261"></div><p>A paper released in the journal <a href="https://affiliate.insider.com?u=https%3A%2F%2Fwww.nature.com%2Farticles%2Fs41558-022-01426-1">Nature on August 8</a> suggests that most of the human pathogens on Earth will be "aggravated" by climate change in some way. Many of them already have been. </p><p>"Insect-borne diseases are <a href="https://www.cdc.gov/lyme/stats/graphs.html">really changing their patterns</a>, because the insects that carry them now have a much broader range," Rubin said, <a href="https://www.who.int/news-room/feature-stories/detail/the-history-of-zika-virus#:~:text=First%20identified%20in%20Uganda%20in,countries%20experiencing%20Zika%20virus%20outbreaks.">citing the way that Zika</a> — once a disease contained to Africa — has been allowed to spread across Asia and the Americas. </p><p><a href="https://www.ecdc.europa.eu/en/chikungunya-monthly">Chikungunya</a>, too, is now a global disease, not the regional threat it once was.</p><p>"The tropics has moved into Europe and North America," Varma said. </p><h2>FOUR: Not enough routine vaccines for kids</h2><div type="image" title="A boy getting the polio vaccine" height="2250" width="3000" msid="93614988" hostid="261"></div><p>During the pandemic, vaccination rates plummeted across the globe in a way that hasn't been documented in decades. The <a href="https://www.who.int/news/item/15-07-2022-covid-19-pandemic-fuels-largest-continued-backslide-in-vaccinations-in-three-decades">WHO calls it</a> the "largest sustained decline in childhood vaccinations in approximately 30 years." </p><p>Add to that the vaccination <a href="https://www.businessinsider.com/what-is-vaccine-court-is-it-real-2019-3">backsliding that was already underway in many rich countries</a>, fueled by <a href="https://www.businessinsider.com/experts-fact-check-vaccine-claims-by-robert-malone-rogan-podcast-2022-2">misinformation</a> and vaccine hesitancy, and it was inevitable that an uptick in vaccine-preventable disease spread would happen once lockdowns, social distancing, and masking measures eased. </p><p>"We need everyone to be getting vaccinated, or we all face risks," Varma said. </p><p>In some areas of Rockland County, New York, where polio has left at least one young, unvaccinated man paralyzed this year, <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7133e2.htm?s_cid=mm7133e2_w">just 37% of little kids are up to date</a> on their polio vaccines. (For context: nationally, nearly 93% of babies are vaccinated against polio.)</p><h2>FIVE: The whole world is paying the price for years of neglecting developing countries' disease outbreaks</h2><div type="image" title="Provider measures monkeypox vaccine." height="3003" width="4759" msid="93614990" hostid="261"></div><p>"All these years, Africans had monkeypox, nobody did a thing, nobody gave them vaccines," Pai said. "Now, suddenly, all the rich nations are going after — and getting — monkeypox vaccinations?"</p><p>Eventually, he said, "we pay the price" for such "archaic," "parochial," and short-sighted disease management. </p><p>"If monkeypox had been handled better in Africa, it wouldn't have spread around the world. If COVID had been handled better in low and middle income countries, new variants would not have emerged. If Ebola had been contained in West Africa, even before it spread, then it wouldn't have arrived in the US."</p><h2>SIX: Our shifting perception of disease threats </h2><div type="image" title="screenshot of promed map with dots all around the globe on august 16 2022" height="539" width="851" msid="93614992" hostid="261"></div><p>We've also been shaped by our experiences during the pandemic, and we can't help but bring that knowledge into infectious disease news we read now. </p><p>In some cases, it's overblown, Pai said. "Some <a href="https://www.reuters.com/article/us-china-cattle-disease-idUSKCN24G1DK">little outbreak happens</a> in some corner of some market <a href="https://www.nejm.org/doi/full/10.1056/NEJMc2202705">in China</a>, immediately everybody across the world is freaking out."</p><p>In many, heightened concern is <a href="https://www.npr.org/sections/goatsandsoda/2022/07/28/1114183886/a-doctor-in-nigeria-tried-to-warn-the-world-that-monkeypox-had-become-a-global-t">warranted</a>.</p><p>These days, scientists also have better tools than ever for noticing what's going on — <a href="https://www.bu.edu/neidl/2021/12/southern-africa-is-not-a-hotbed-of-variants-its-just-very-good-at-sequencing-and-spotting-them/">sequencing</a> viruses, testing cases, and sounding alarm bells they couldn't have years ago. </p><p>"COVID has really changed the way we notice these things," Rubin said, speaking about average news readers and professional scientists alike. "Every day there's a disease of some sort <a href="https://promedmail.org/">reported somewhere</a> in the world," he said — and that is, in part, because we are all paying more attention to them than we used to. </p><h2>SEVEN: We're still not sure how COVID exposure has affected our immune systems</h2><div type="image" title="Dr. Francis S. Collins, who serves as the Acting Science Advisor the president is the highest-paid White House employee." height="1828" width="2438" msid="93614993" hostid="261"></div><p>New disease threats are especially alarming right now because it's <a href="https://www.cdc.gov/ncird/investigation/hepatitis-unknown-cause/parents.html/">not yet clear</a> to us what effect <a href="https://www.sciencedirect.com/science/article/pii/S2531043721000040">prior COVID</a> could be having on our <a href="https://www.businessinsider.com/common-long-covid-symptoms-hair-loss-vertigo-low-libido-2022-7">immune defenses</a>. </p><p>"We will learn in the coming months and years," Pai said, "whether COVID does mess up the immune system to some degree or the other, which makes us more susceptible." </p><p>Already, he's worried that doctors' overdependence on steroid <a href="https://www.cdc.gov/drugresistance/pdf/covid19-impact-report-508.pdf">and antibiotic prescriptions</a> during the pandemic may spur more <a href="https://www.wired.com/story/the-pandemic-fueled-a-superbug-surge-can-medicine-recover/">fungal infections, superbugs,</a> and antimicrobial resistance.</p><h2>Another pandemic is coming. We could stop it — but experts fear 'we've given up'</h2><div type="image" title="A sign outside of a New York clinic reads &quot;appointment only&quot;" height="1333" width="2000" msid="93614995" hostid="261"></div><p>Scientists <a href="https://www.pnas.org/doi/10.1073/pnas.2105482118">estimate our odds of experiencing another pandemic</a> "may double in coming decades," as disease outbreaks fueled by this wide array of interrelated, complex factors become more and more common.  </p><p>But when it comes to disease prevention, "you're better off <em>not</em> thinking that the 10 plagues have been released simultaneously," Rubin said. "Each disease is distinct," with different biological features, distinct reasons for emerging, and varying modes of transmission and prevention.</p><p>"The answer is more investment in public health, right?" Pai said. It's often "stuff that we've given up on," he said, interventions that are "undermined," like clean drinking water, good sanitation, vaccines, equitable access to treatment and clinical care, as well as robust disease research.</p><p>"Our racism in the way we think about infectious diseases," he says, "eventually will come back and haunt us — which is what is happening." </p>

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