Stopping the Gaps in Epidemic Preparedness

First isolated in Malaysia in 1999, Nipah virus rapidly went from unknown to endemic in Bangladesh, which has seen an outbreak almost every year since 2001 (see Nikolay et al., pages 1804–1814) . Large gaps remain in our understanding, however, such as how the virus crossed India to spark an epidemic in Kerala on that country’s southwestern coast in 2018.

Several life-threatening viruses have been identified for the first time in the 21st century, including the severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS) coronaviruses. An association between Zika virus infection during pregnancy and microcephaly came to light only in 2015. Once seemingly confined by public health measures to sporadic episodes in rural areas, Ebola virus disease broke free in 2014, reaching urban centres and killing more than 11,000 people. Like all epidemics, it drew resources away from other critical health care needs and left a legacy of distrust and disconnection.

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