Emerging infections you should know about and how to prevent them

• Infectious disease spread is increasingly common due to travel, human-animal contact, and climate trends.
• Experts shared the emerging diseases they’re most concerned about and how to prevent them.
• This article is part of “IDWeek,” a series on one of the leading conferences for infectious-disease experts.

It’s been more than 10 years since the 2014 Ebola epidemic, when the often-fatal viral infection spread from remote villages in Central Africa, leading to the world’s largest outbreak since the virus’ 1976 discovery.

Today, we may be less prepared than we previously were for emerging infectious disease outbreaks, said Dr. Krutika Kuppalli, an internal medicine expert who specializes in infectious disease, during her presentation at the annual IDWeek conference for professionals and students in the field.

Infectious disease outbreaks are a mounting global health challenge, despite decades of innovation in vaccines and diagnostics. Today, public-health experts are documenting a growing number of emerging infectious diseases, including antibiotic-resistant E. coli, dengue fever, and Candida auris fungus.

An emerging infectious disease is a novel infection that has appeared for the first time, like COVID-19, or one that previously existed and re-emerged, and is spreading rapidly — either in terms of the number of cases, or because it’s popped up in a new area, according to the World Health Organization.

While diagnostic technology and surveillance methods have improved to catch more of these emerging diseases, climate trends, increased human-animal interaction, global travel, and antibiotic resistance — when germs evade antibiotics, thereby making infections, complications from routine surgeries, and cancers more difficult to treat— have contributed to harder-to-treat and more easily spread infections, Kuppalli said during her IDWeek presentation on emerging infectious diseases.

She went on to say that following the COVID-19 pandemic, funding for the prevention of infectious disease outbreaks decreased, as tends to be the case after most complex outbreaks. “Money tends to go away when an outbreak is over, but more consistent funding for prevention is needed,” Kuppalli said.

To better understand the current state of infectious diseases and how to prevent their spread, Business Insider asked experts to share the emerging infections they want the public to know about, and what can be done to prevent and treat them.

Carbapenem-resistant E. coli (CREC)

What it is: This bacterium is an antibiotic-resistant strain of E. coli, which is part of a healthy human’s gut makeup but can also cause infections, said Dr. Yohei Doi, an internal medicine doctor and an IDWeek chair representing the Infectious Disease Society of America.

It spreads through hand-to-hand contact, infected wounds, and feces containing the bacteria. In rare but reported cases, carbapenem-resistant E. coli has spread between animals and humans, sometimes without the animals or humans showing typical signs of infection, such as diarrhea, urinary tract infections, or pneumonia.

Who’s at risk: Though antibiotic-resistant E. coli is not a risk for normally healthy people, those who are sick and recovering in healthcare facilities are at an increased risk of infection, as per the CDC website.

Children under 5, adults over 65, and travelers also have an increased risk of infection.

Challenges to prevention and treatment: Doi said that antibiotic-resistant E. coli produces an enzyme called NDM that breaks down carbapenem antibiotics, an injectable treatment for life-threatening bacterial infections such as pneumonia, gangrene, severe urinary tract infections, and endocarditis.

This particular medicine is usually “very potent and generally reserved for the sickest patients,” but is increasingly shown to be ineffective for treatment, Doi said.

Nontuberculous mycobacteria (NTM)

What it is: NTMs are microbes commonly found in soil and water, some of which can cause lung infections.

People can catch this infection when they come into contact with NTM in their homes or outside, Idowu Olawoye, a microbiologist, bioinformatician, and postdoctoral research associate at Western University in Ontario, told Business Insider. “In your pool, in your garden, just anywhere you think of, they’re literally there,” he said.

Who’s at risk: NTMs can make anyone ill, but they’re more likely to affect people with existing lung conditions such as asthma, COPD, cystic fibrosis, or bronchiectasis, as well as people with a weakened immune system or those who are elderly.

Common symptoms include shortness of breath, coughing, weight loss, and fatigue.

Challenges to prevention and treatment: Some NTM strains that commonly make people sick, such as Mycobacterium avium complex, are slow-growing — taking around 10 to 20 days to grow a detectable colony in a human sample in a lab setting — which makes them hard to study and diagnose.

Olawoye said that he is worried about the rise of NTMs because they are resistant to several antibiotics, making them hard to treat. “They have lots of antimicrobial resistance genes, and they can undergo or develop mutations that also prevent drugs from working,” he told Business Insider.

Mycoplasma genitalium (Mgen)

What it is: Cases of sexually transmitted infections (STIs) caused by the pathogen Mycoplasma genitalium are on the rise.

“It was discovered in the 1980s, and it’s been around but not really known. But all of a sudden we’ve seen increasing cases,” Olawoye said.

Who’s at risk: Mgen is passed on through vaginal or anal sex without a condom, and can cause nongonococcal urethritis, inflammation of the urethra, in men, and cervicitis, inflammation of the cervix, in women. Left untreated, Mgen can lead to pelvic inflammatory disease, infertility, and ectopic pregnancy in women. It is not known if Mgen causes long-term health problems in men.

Challenges to prevention and treatment: Mycoplasma genitalium is becoming more resistant to antibiotics typically used to treat it, making it harder to contain than before, according to the CDC.

Dengue fever

What it is: Mosquitos infected with the virus — of which there are four types — spread the infection to humans when they bite them.

Symptoms — like aches and pains in the eyes, bones, or muscles, nausea, vomiting, and rashes — tend to start two weeks after someone has been bitten. According to the CDC, most people typically recover from the infection after a week.

Who’s at risk: People in high-risk areas such as Central and South America, Southeast Asia, the Caribbean, and the Pacific Islands have a greater risk, since there are more infected mosquitos and higher transmission rates.

Challenges to prevention and treatment: Dengue is a prime example of climate-fueled infectious disease spread, Doi told Business Insider. “As the climate changes, we will see infections that were confined to the tropics and subtropics move up poleward,” he said.

Kuppalli noted that recent cases of local dengue fever transmission have been reported in California, Texas, Hawaii, and Arizona.

“These are infections that we didn’t have to consider in the US before,” Doi said.

Currently, there’s no cure for dengue fever, and treatment focuses on managing symptoms and preventing complications. The best way to avoid getting dengue fever is to avoid mosquito bites. There’s also a vaccine available for children between the ages of 9 and 16 who live in high-transmission areas and previously had the disease.

Candida auris fungus (C. auris)

What it is: Candida auris is a type of yeast that is spread through surface contact — typically via equipment, bed rails, and door knobs in medical facilities. When it spreads in the body, it can lead to skin and ear infections and, in severe cases, bloodstream infections, as per the CDC website.

It’s an emerging threat due to a new species of the fungus, which has popped up over the last decade and is resistant to typical treatment methods like antifungal drugs, Doi said.

Who’s at risk: C. auris mostly spreads among people with weakened immune systems who are in medical settings, like hospital patients and nursing home residents, said Doi.

It can spread through breathing tubes, feeding tubes, and catheters, so patients who require these medical devices have an increased risk of infection, the CDC website says.

Challenges to prevention and treatment: Often, someone can have this fungus on their skin without realizing it, according to the CDC.

Since treatment options for C. auris fungus are limited, mortality rates are high once someone is severely infected.

Aspergillus

What it is: Derived from mold, Aspergillus is a fungus that spreads via airborne spores and can lead to the disease aspergillosis.

It can cause a range of symptoms from mild to severe, including coughing, shortness of breath, congestion, headaches, fatigue, and coughing up blood. Mild symptoms are more common than severe ones, as per the CDC website.

Notably, the majority of people inhale this invisible-to-the-eye fungus every day and remain healthy.

Who’s at risk: Typically, people don’t become severely ill after inadvertently inhaling Aspergillus fungus. However, people with weakened immune systems or chronic lung health problems are more susceptible to extreme sickness. Those who have undergone organ or stem cell transplants are also at risk of severe infection, according to the CDC.

Challenges to prevention and treatment: Doi said that the global widespread use of fungicides in agriculture is likely driving the spread of Aspergillus, which is commonly treated with antifungal medication.

This particular fungus has become largely resistant to the most commonly used antifungals in humans, making it increasingly difficult to treat, Doi said.

How to treat and prevent emerging infectious diseases

To better manage infections with medicines that are available, patients and clinicians should work together — especially when it comes to antibiotic treatments, said Doi. “Using them wisely protects everyone and helps preserve the medicines that have saved more lives than almost any other medical advance,” he told Business Insider.

On a systematic level, Kuppalli said that more funding is needed to improve prevention strategies, such as surveillance-data sharing among countries and improved access to vaccines, diagnostics, and treatments in areas where these resources may be limited, resulting in a greater likelihood of an outbreak.

Finally, if someone has symptoms that they believe could be signs of an infectious disease, Kuppalli said to contact the CDC immediately.

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