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The dynamic landscape of emerging viral infections

Pediatric Research volume 95, pages 411–413 (2024)Cite this article

While there has been substantial progress in the fields of diagnostics and public health surveillance over recent decades, the record number of viral epidemics and pandemics during these years is not fully attributable to an increased detection capability. Rather, one cannot ignore the ominous role of climate change as a major factor leading to shifts in the prevalence of zoonotic diseases. The global rise in temperatures and alterations in precipitation patterns create fertile grounds for vectors to proliferate and expand to new regions, thus facilitating the spread of viral infections. According to the World Health Organization (WHO), dengue has seen a 30-fold increase in global incidence over the last five decades, with approximately half of the world’s population now at risk.2 Peru has been among the most affected countries in 2023, with a 5-fold increase in overall cases and nearly 48 000 affected children, leading to the declaration of a country-wide state of emergency. El Niño Southern Oscillation in addition to unprecedented rains caused by cyclone Yaku, the first cyclone to hit Peru in over 40 years, provided optimal conditions for vector spread and disease transmission.3 Chikungunya has shown a similar surge, spreading its wings across continents.4 Moreover, the effects of climate change also have the potential to affect the prevalence of vector-borne infections at higher altitudes. Although once considered a natural barrier to certain diseases, as temperatures rise, previously inhospitable mountainous regions become more habitable for vectors, extending the reach of arboviral infections to higher elevations.5 Such shifts necessitate a reevaluation of our understanding of traditional epidemiological boundaries.

Agricultural and farming practices also play a critical role in the emergence of viral threats. The use of pesticides, deforestation, selective livestock breeding, and greenhouse gas emissions can alter the dynamics of vector habitats and expose communities to novel risks. The tick-borne Heartland virus, for instance, has been associated with agricultural activities, being first identified in 2 U.S. farmers from Missouri.6 Similarly, Langya henipavirus was recently identified in the Shandong and Henan provinces in China and was initially observed in farmers who had been in contact with shrews.7 Changes in land use patterns also directly impact the exposure of people to novel viruses, as seen in the expansion of urban areas into previously untouched landscapes where viruses like Zika and Nipah reside and where the proximity of human settlements to altered landscapes increases the risk of spillover events.8 Cache Valley virus (CVV), another tick-borne pathogen previously thought to only affect livestock, has recently emerged as an agent causing severe disease in humans, including flu-like illness, encephalitis, and death.9 CVV case monitoring is especially important as it is known to cause severe malformations and fetal deaths in sheep, and it is still to be determined if similar in utero effects will be seen in human infections.

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Fig. 1: The global extent of newly emerging, re-emerging, and “deliberately emerging” infectious diseases from 1981 to the present (2020).

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Authors and Affiliations

  1. Division of Pediatric Infectious Diseases, The University of Alabama at Birmingham, Birmingham, AL, USA

    Maria S. Rueda Altez & David W. Kimberlin

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Correspondence to Maria S. Rueda Altez.

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Dr. Rueda-Altez has no conflicts of interest to disclose. Dr. Kimberlin was the site Principal Investigator on Gilead’s pediatric study of remdesivir; all monies went directly to UAB.

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Rueda Altez, M.S., Kimberlin, D.W. The dynamic landscape of emerging viral infections. Pediatr Res 95, 411–413 (2024). https://doi.org/10.1038/s41390-023-02974-8

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