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High-Consequence Pathogens

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What Does High-Consequence Pathogens Mean?
The January 2018 issue of Emerging Infectious Diseases features high-consequence pathogens. A pathogen is a biological organism that causes disease or illness in its host. But if any pathogen can cause disease, which in itself is a negative consequence, why are only some pathogens considered to be of “high consequence”?
High-consequence pathogens have one or more of the following features:
• potential to cause epidemics or pandemics
• infect/affect many people
• spread rapidly in a short time
• infection results in high cost to society (loss of worker productivity)
• infection results in high cost to the healthcare system

What Are Some Diseases Caused by High-Consequence Pathogens?
High-consequence pathogens include viruses, bacteria, and prions. Here are examples of diseases caused by high-consequence pathogens.

Viral Bacterial Prion
Poxvirus infections
Ebola virus disease
Rabies
Hantavirus pulmonary syndrome
Marburg hemorrhagic fever
Rift Valley fever
Smallpox*
Zika
Actinomycoses & nocardiosis
Anthrax
Brucellosis
Buruli ulcer
Glanders
Leprosy (Hansen disease)
Leptospirosis
Melioidosis
Bovine spongiform encephalopathy (mad cow disease)
Chronic wasting disease
Creutzfeldt-Jakob disease (classic and variant)
*In 1980, smallpox was eradicated (eliminated); however, the virus remains in secure laboratories for use in developing vaccines, diagnostic tests, and drugs, to protect people should it ever be used for bioterrorism.

What Is Being Done with Regard to High-Consequence Pathogens?
Scientists are working to protect the public from these pathogens by
• investigating and monitoring outbreaks
• identifying new pathogens and diseases
• seeking better ways to prevent (e.g., vaccines, behavior), diagnose (e.g., laboratory tests), and treat (e.g., medications) those diseases
• developing emergency response plans (for potential or actual outbreaks)

EID Articles about High-Consequence Pathogens
Learn more about high-consequence pathogens from these articles from the January issue of Emerging Infectious Diseases. For a quick overview, read the abstracts for the articles. Use the journal’s Advanced Article Search to find more articles.
Viral diseases
• Expected Duration of Adverse Pregnancy Outcomes after Zika Epidemic explores how long pregnant women are at risk after a Zika epidemic.
• Investigation of Canine-Mediated Human Rabies Death, Haiti, 2015 reports the challenges of eliminating human death from rabies in Haiti.
• Postmortem Findings in Patient with Guillain-Barré Syndrome and Zika Virus Infection describes development of Guillan-Barré syndrome in a Zika patient.
• Sensitivity and Specificity of Suspected Case Definition Used during West Africa Ebola Epidemic examines how to define a "suspected" case of Ebola.
Bacterial diseases
• Increased Severity and Spread of Mycobacterium ulcerans, Southeastern Australia describes how Buruli ulcer is spreading in Southeast Asia.
• Leprosy in Nonimmigrant Canadian Man without Travel outside North America, 2014 describes how a man who never left North America acquired leprosy.
• Melioidosis, Singapore, 2003–2014 describes trends in melioidosis cases in Singapore.

Sources
1. Belay ED, Monroe SS. Low-Incidence, High-Consequence Pathogens. Emerg Infect Dis. 2014;20(2):319-321. https://dx.doi.org/10.3201/eid2002.131748
2. CDC Division of High-Consequence Pathogens and Pathology Factsheet

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