Ebola, SARS, swine flu, MERS. With the reality that a previously unknown animal virus has started infecting people, the world faces a recurring question: What does one call it?
The pneumonia-causing virus, which is spreading rapidly in China and beyond, is currently being identified as 2019-nCoV, shorthand for a novel or new (i.e. “n”) coronavirus (CoV) that was first detected in 2019. The disease it causes doesn’t yet have a name, either, though Wuhan SARS or Wu Flu are among of the options being thrown around on the internet.
None of these is likely to be the virus’ or the disease’s permanent name. They almost certainly would be unacceptable to the Chinese, and to the World Health Organization, which discourages the use of place names in the naming of diseases. As for the virus, the longer it spreads the less novel it becomes. 2019-nCoV is a bit like calling a daughter “the girl born in 2019.” Given that another daughter might be born in 2021, a name that might more easily distinguish between the two is probably in order.
So how to name it? And who gets to name it?
In this case, a committee will be convened by the WHO to take up the challenge, according to officials there, though it isn’t clear when, or who will be on the panel, or whether the WHO intends the committee to name both the virus and the disease it causes.
Traditionally naming rights actually belong to the scientists who first isolate a virus, who will at some point propose a name to a study group of the International Committee on Taxonomy of Viruses, said Ralph Baric, a coronavirus expert who sits on that panel. That group’s next scheduled meeting is in May. It’s possible the WHO could work in conjunction with the committee to name the new virus.
Ron Fouchier, a Dutch virologist who knows a thing or two about virus naming controversies, said he contacted the former chair of the coronavirus study group on Wednesday and urged him to start the process of coming up with a workable name sooner rather than later.
“If nobody steps in quick, then I think that the name the lay press is going to give it is probably what’s going to fly,” Fouchier told STAT.
That might mean this virus and disease become known by the name of the city currently quarantined to stop the virus’s spread, Wuhan.
“NCoV is not going to fly for long,” Fouchier said. “And if they don’t do it in an authoritative way, then other people will come up with a name.”
It was the WHO that chose the name SARS and was involved in the negotiations that settled on the name MERS — though WHO now uses MERS as an example of what not to do when naming a disease since it evokes a specific region. (The acronym is short for Middle East respiratory syndrome.) That, experts now agree, can be seen as disparaging.
The scientists who investigated the first known Ebola outbreak were aware of the risk of leaving an indelible stain on a particular place. That team, led by legendary virus hunter Karl Johnson, traveled to Yambuku, in what was then Zaire — now the Democratic Republic of the Congo — in 1976 to try to determine what was killing people who worked in or sought care at a hospital run by Belgian nuns.
Johnson proposed that the virus be called Ebola, after a river he spotted on a map, roughly 40 miles away from where the outbreak was taking place, according to a report of the outbreak response, published in 2016. Yambuku was spared the infamy of being the name of a highly deadly virus.
In the case of what is now known as SARS, officials at the WHO moved early to name the new disease. The global health agency alerted the world to the fact a new virus was spreading from China on Wednesday, March 12, 2003. By Saturday, the disease had a name.
“The reason we named it was we didn’t want the press or some other group to name it with a stigmatizing name,’’ said Dr. David Heymann, who led the WHO’s SARS response and who was one of a small group of people who came up with the name.
Heymann, who is now a professor at the London School of Hygiene and Tropical Medicine, said they wanted an easy-to-say acronym, like AIDS or HIV, that would also be easy to remember. They decided on words that described the condition, formed an acronym, and didn’t — or so they thought at the time — label any area as the source of the virus.
Severe acute respiratory syndrome, or SARS, was born. It was only later that the similarity to Hong Kong’s status as an SAR — special administrative region — within China was recognized. Hong Kong suffered mightily from SARS and did not appreciate the fact that the virus, which originated in China, appeared to hint at a Hong Kong origin.
Likewise the naming of MERS created bad blood when a new coronavirus that jumped from camels to people emerged in Saudi Arabia in 2012.
When the virus was first isolated at Erasmus University in Rotterdam, in the Netherlands, it was called HCoV-KSA1, for human coronavirus from the Kingdom of Saudi Arabia. The kingdom — which was already mad that a specimen from a sick Saudi had been shipped to the Netherlands without its knowledge — got madder.
Fouchier, who led the work to isolate the virus, recalled the Dutch team then tried EMC1, thinking it could name the pathogen after Erasmus Medical Center. The Saudis were still not happy.
The International Committee on Taxonomy of Viruses, the Saudi Arabian government, and the WHO eventually negotiated the issue and settled on MERS.
Since then, the WHO has published guidance on the naming of new human diseases. Don’t name them after countries or regions. Don’t name them after people. Don’t name them after the animals they come from — the swine flu pandemic of 2009 was quickly relabeled when angry pork producers complained about sharp drops in pork sales.
It’s easier to describe what viruses and diseases should not be called than to suggest what might work.
“People in my lab are trying to come up with names,” said Baric, a coronavirus researcher at the University of North Carolina. Two candidates have already been rejected: South East Asia respiratory syndrome, or SEARS (for obvious reasons) and Chinese acute respiratory syndrome, CARS, because “that kind of sounds stupid,” he said.