Colds and flu

23 May 2013

The name game of deadly viruses

For a pathogen with such a short history, the mysterious new virus killing people in the Middle East and Europe has already had an amazing array of names.


For a pathogen with such a short history, the mysterious new virus killing people in the Middle East and Europe has already had an amazing array of names.

It first surfaced last year as "human betacoronavirus 2c EMC", but the suffixes "2c England-Qatar, "2C Jordan-N3", "England 1" have also appeared and many scientists have resorted to "novel coronavirus" - new crown-shaped virus - instead.

While the World Health Organisation (WHO) says the virus and the severe infections and deaths it has caused are "alarming" and need to be tracked, none of its names is especially helpful.

"A virus is only 'novel' until the next one comes around," Raoul de Groot, head of the Coronavirus Study Group (CSG), said of the catchiest of the titles it has acquired so far.

MERS could be the new name

So with the death toll from the 42 cases identified at 21 and expected to rise - de Groot's group has come up with a new name: "Middle East Respiratory Syndrome" or MERS, since all the cases have had a direct or indirect connection to the region.

The CSG, which published the name in the Journal of Virology last week, said it had been endorsed by the Saudi, Dutch and British scientists who discovered it, the WHO's European office and the Saudi health ministry.

But naming deadly new viruses is fraught with sensitivity, and the signs are this matter has yet to settle.

Difficult history in human diseases

Human disease is littered with examples of fractious, sometimes furious rows over what emerging pathogens are called.

Some 30 years ago, when the human immunodeficiency virus, or HIV, was discovered, it was named "GRID", or "gay-related immune deficiency", helping to spread the slur "the gay plague".

It was not until it became clear the sexually transmitted virus was also infecting heterosexuals and haemophiliacs, that GRID was replaced with the more accurate HIV.

More recently, the scientific "H1N1" was the name that stuck for the pandemic flu strain that swept the world in 2009/2010 after earlier suggestions proved too sensitive.

An Israeli health minister objected to "swine flu" on religious grounds and "Mexican flu" caused offence to a nation.

When scientists called a "superbug" enzyme that makes bacteria resistant to almost all known antibiotics "New Delhi metallo beta lactamase", or NDM-1, the Indian health ministry called it "malicious propaganda" to put India in the name.

"Clearly, naming viruses and diseases after ethnicity, religion, gender and lifestyle is potentially stigmatising and offensive, and thus unacceptable," de Groot said.

"All parties involved were acutely aware of sensitivities around geographic naming and the issue has been weighed very carefully," he told Reuters via email.

The MERS decision involved Ron Fouchier of the Erasmus Medical Centre in the Netherlands, Maria Zambon of the UK Health Protection Agency and Ali Mohamed Zaki, an Egyptian microbiologist working at the Dr Soliman Fakeeh Hospital in Jeddah, Saudi Arabia, among others.

Discovering the new virus

All of them played key roles in discovering the new virus.

According to a source close to the discussions, who declined to be identified due to sensitivities surrounding the issue, one suggestion was to name the virus after Zaki as a tribute to his work; he lost his job after going public with his findings.

It is early days, but so far, MERS has not caught on, despite the WHO's European branch saying "the WHO and other committee members strongly urge the use of this name in scientific and other communications".

A "disease outbreak update" issued from the WHO's global headquarters in Geneva on Wednesday referred to the "novel coronavirus" or "nCoV" throughout. MERS did not get a mention.

A WHO spokesman said he was unable to comment on the discrepancy but added that from now on "we are going to be using the new name in all our updates".


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Flu expert

Dr Heidi van Deventer completed her MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 2004 at the University of Stellenbosch.
She has additional training in ACLS (Advanced Cardiac Life Support) and PALS (Paediatric Advanced Life Support) as well as biostatistics and epidemiology.

Dr Van Deventer is currently working as a researcher at the Desmond Tutu Tuberculosis Centre at the University of Stellenbosch.

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