UK health officials have drawn up plans for a “genomic transformation” that aims to detect and treat infectious disease outbreaks faster and more effectively in light of the Covid pandemic.
Insights gleaned from Covid genetics proved crucial as the virus spread across the globe, revealing how the pathogen spread, evolved and responded to a succession of vaccines and drugs developed to protect people.
The UK Health Security Agency (UKHSA) now aims to build on the lessons of the pandemic by incorporating genomics into routine public health practice. The measure aims to strengthen surveillance of outbreaks, reduce cases of infections such as tuberculosis, measles, hepatitis C and HIV/AIDS, and predict the course of future threats, such as bird flu and mosquito-borne diseases and ticks as they gain ground. in a hot climate.
“We changed the way we think about genomics during Covid,” said Dr. Meera Chand, director of clinical and emerging infections at UKHSA. “It’s not that we need to generate large numbers of genomes all the time, it’s that we can use the data to change what we’re doing. Genomics gives you information you can act on, it’s not just a research tool.”
Genomics boost is critical for UKHSA 10-year scientific strategy released Tuesday. Among the plans, which cover infections, radiation protection, the health impact of the climate crisis, and vaccine development, is a commitment to the “100-Day Mission,” which aims to have diagnostic tests, medicines, and vaccines ready to implement in 100 days. of a new emerging pandemic threat.
One way to detect outbreaks early is to monitor the genomes of viruses and bacteria circulating in the population. Any abrupt change in the normal pattern of a pathogen may indicate that a particular strain is emerging, perhaps because it has evolved to evade front-line drugs.
The same approach can highlight when seemingly sporadic infections belong to a cluster. Rather than waiting for a pattern of sick patients to emerge from GP or hospital records, genomic analyzes of microbes, for example listeria and salmonella, can identify cases driven by the same source. Last year, UK health officials unleashed a Global Kinder Surprise Egg Recall after genomics revealed a cluster of antibiotic-resistant Salmonella infections linked to a chocolate factory in Belgium. “We will always need shoe leather epidemiology, there is no escaping that, but genomics can support it to be fast, highly accurate and make us respond faster and more definitively,” Chand said.
Another strategy could turn hospital intensive care units into an early warning system for dangerous outbreaks. Instead of testing patients only for common infections, such as influenza, scientists could use genomics to identify all pathogens in a patient’s lung swab. While the data can be difficult to interpret (many errors will not be significant), the approach can detect new and emerging infections that would otherwise be missed. A similar “pathogen-agnostic” genomics approach helped uncover how different viruses combined to drive a rise in cases of life-threatening hepatitis in vulnerable children last year.
Chand said not knowing what the next infection would be presented a challenge. “In all likelihood, it will be a pathogen that we weren’t expecting, or possibly never seen, and we need to have this kind of focus in place to support us.”
According to the UKHSA strategy, humans have been affected by more than 330 new and emerging infectious diseases since the 1940s, almost two-thirds of which appear to have been spread by animals. The likelihood of more to come after Covid, Sars, Mers and mpox is increasing, the report adds, given increased human-animal contact and the ease of spread as a result of global trade and travel.
Once again, health officials hope to apply genomics. The devastating outbreak of bird flu has killed tens of thousands of wild birds in the UK and the virus has been detected in mammals such as foxes. Through genomics, scientists can monitor how the virus evolves. “That’s a very active area for us,” Chand said. “We take international data every week and try to understand what we’re seeing in the data and what the implications might be.”