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Calling it what it is

In 2015, the World Health Organization (WHO) issued guidelines for the naming of new human infectious diseases. The current global outbreak of the SARS-CoV-2 virus underscores the need to be accurate with our language, particularly as it relates to pandemics.

The Ebola River in the Democratic Republic of the Congo is known as Legbala, or ‘white water’, in Ngbandi. It is also the source of the name of the Ebola virus, which was discovered in 1976. ‘Ebola’, the name for the filovirus that causes hemorrhagic fever, is actually a misnomer, given that the disease was first identified more than 100 kilometers away in a town called Yambuku. What is the explanation for this discrepancy? One of the discoverers of the virus, Peter Piot, purposely avoided naming the new virus after the town, thus preventing Yambuku and its citizens from being permanently associated with this serious infectious disease. If more than 40 years ago, this sense of stigmatization was acute enough to influence the naming of a newly identified virus, we should certainly be attuned to it today.

There are, of course, other examples of infectious diseases named after geographic locations (for example, Lyme disease). Although this method of naming could be considered factual or even neutral, there are risks and downsides to prominently using geography for infectious-disease names. First, with our ability to rapidly sequence and analyze genomes, there are now much more precise ways to name infectious agents. Second, geographically based names are not always accurate; the 1918 influenza outbreak now often referred to as the ‘Spanish’ flu did not even originate in Spain. Finally, and most importantly, nominally associating an area with an infectious disease can potentially imply a causality, link or connection where none exists. This in turn can lead (and indeed has led) to instances in which entire groups are blamed for carrying or spreading disease, thus resulting in irrational responses such as prejudice or, in worse cases, even violence.

To introduce best practices for the naming of newly discovered infectious diseases in humans, the WHO released guidelines to help standardize the process of naming and to avoid conventions that lead to stigma. Recommended disease nomenclature calls for avoidance of locations, people’s names, and specific foods, animals or other culture- or occupation-specific identifiers. These guidelines are in place to prevent the negative effects of stigmatization, misunderstanding or offense.

Accordingly, the novel coronavirus that was first reported in cases in Wuhan, China in December of 2019 has officially been named SARS-CoV-2, and the disease that it causes has been named COVID-19. Although viruses have specific geographic origins, it should be obvious that they do not have a race or ethnicity. This current outbreak is a global pandemic, so stigmatizing entire regions or people by naming infectious diseases after a location is unhelpful. That does not mean that there should be no scrutiny of the conditions that lead to viral outbreaks and the subsequent patterns of global spread. Pertinent to the current pandemic, a 2015 paper published in Nature Medicine highlighted a potential risk for the re-emergence of a severe acute respiratory syndrome coronavirus from existing viruses found in bat populations. SARS-CoV-2 is now thought to have jumped from an animal host to humans, and the likely point of transfer was in a wildlife market in the Hubei province of China. We should rationally analyze the origins and epidemiology of this disease to develop effective preventive measures for similar viral disease outbreaks in the future. We can do this without stigmatizing entire areas and ethnicities.

During these challenging times, our hope is that society will choose to embrace science, stick to facts, and use precision in language and descriptions. If the outbreak of SARS-CoV-2 has taught us anything, it is that we are a global community whose actions and choices have consequences for others. We should strive for unity and seek out opportunities where we can help and support, rather than divide and blame.

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Calling it what it is. Nat Genet 52, 355 (2020).

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