We are often asked the important question of "what is the priority?" when monitoring an entire world of biological activity. As of today, here is the answer to that question, keeping in mind we are based in the United States with a bias towards those biological agents that are potentially capable of acutely disrupting US-based infrastructure. We use different prioritized reporting requirements for different clients / countries as appropriate.
- A/H3N2 variant influenza virus within the US
- A/H3N2 seasonal influenza virus within the US
- A/H1N1 seasonal influenza virus within the US
- (other type A influenza virus variants within the US)
- RSV/adenovirus/metapneumovirus/influenza virus combinatory effect on medical infrastructure as winter approaches
Note there is no mention of A/H5N1 or other HPAI strains, novel coronvirus, Ebola virus, or other attention / headline-grabbing pathogens or marketing campaigns by research programs. We always keep an eye on A/H5N1 reporting, for example, but until indicators of sustained human-human transmission have been reported it remains a low priority. One must understand the associated indicator pattern if one does not have access to the direct medical or laboratory diagnostic data, of course.
Prioritized tracking bullets 6, 7, 8, 9, 10, etc include issues such as pertussis, however these have not proven to be acutely disruptive to the infrastructure at this juncture.
This is operational reality from our point of view, which is obviously not "hot and sexy". It is always more interesting and exciting to talk about the most dramatically deadly pathogens such as novel coronavirus, Ebola, or H5N1. But therein is the bias in human communication behavior: death > high morbidity > mild illness > largely asymptomatic illness.
One of the biggest responsibilities for a operationally-minded biosurveillance analysts is to focus on realistic probabilities and ask the question, "so what?"