Why Do Deadly New Diseases Such as MERS-CoV Have Such Complicated Names?

Answers to your questions about the news.
June 20 2013 4:08 PM

Who Gets to Name New Diseases?

The tangled origins of a deadly new virus called MERS-CoV.

A man, wearing a surgical mask as a precautionary measure against the novel coronavirus, walks near a hospital in Khobar city in Dammam May 21, 2013. Saudi Arabia has reported another case of infection in a concentrated outbreak of a new strain of a virus that emerged in the Middle East last year and spread into Europe, the World Health Organization (WHO) said on May 18, 2013.
A man wears a surgical mask as a precautionary measure against the novel coronavirus in Khobar city in Dammam on May 21, 2013. Saudi Arabia has reported another case of infection in a concentrated outbreak of MERS-CoV, which emerged in the Middle East last year and spread into Europe, the World Health Organization said on May 18, 2013.

Photo by Stringer/Reuters

The new Middle East respiratory syndrome coronavirus, known as MERS-CoV, may be deadlier than severe acute respiratory syndrome, or SARS, according to an article published Wednesday in the New England Journal of Medicine. Older infectious diseases carried simpler names like “mumps” and “tuberculosis.” Now acronyms predominate. Who’s picking these names?

Committees, consortiums, and agencies, mostly. The MERS-CoV naming saga is an extreme example of the bureaucratized process by which diseases are now labeled. The virus was isolated in mid-2012 by a scientist in Saudi Arabia and initially carried the name human coronavirus EMC. As doctors around the world began to see new cases and learned about the bug, it picked up more names, including human betacoronavirus 2c England-Qatar, human betacoronavirus 2C Jordan-N3, and betacoronavirus England 1. The lab group that sequenced the virus genome—and was criticized for trying to patent its findings—named the pathogen human coronavirus-Erasmus Medical Center (HCoV-EMC), after the group’s employer. The Centers for Disease Control and Prevention and the World Health Organization, hoping for a single name to emerge, initially stuck with novel coronavirus, or nCoV, as a placeholder. On May 15, more than eight months after the virus was isolated, the International Committee on Taxonomy of Viruses announced the name Middle East respiratory syndrome coronavirus. Although the World Health Organization frowns upon geographic names, fearing they could lead to discrimination, it blessed the choice, which appears to have stuck.

The accelerating pace of medical discovery has created these messy modern naming habits. In decades past, names developed by medical consensus before much was known about the disease. In 1976, for example, 200 attendees at a convention of the American Legion came down with pneumonia. It took a full year before the CDC identified the bacteria responsible. By then, the name Legionnaires’ disease had become widespread. 

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Once the public and the scientific community latch onto a name, it can be difficult to shake. In 2009 pork producers complained that the name “swine flu” was damaging the industry and “ruining people’s lives,” in addition to being scientifically inaccurate. (Inaccuracy isn’t necessarily an obstacle—malaria is not caused by bad air, but by the mosquito-borne Plasmodium protozoa.) Spurred by financial concerns, Agriculture Secretary Tom Vilsack quickly switched to “H1N1 virus.” The CDC, however, argued that the name wasn’t specific enough for medical researchers because there are other strains of H1N1. Bucking the administration, the agency kept calling the disease “swine flu” for weeks. (Although the CDC has since accepted “2009 H1N1 virus,” infectious disease specialists often call it “swine flu” for clarity.)

Name changes do happen occasionally. Consider the disease once known to the medical community as gay-related immunodeficiency disease, or GRID. After doctors discovered the illness in hemophiliacs and straight women in 1982, the CDC—with little fanfare—began referring to the disease as AIDS. Tuberculosis was known as “consumption” for hundreds of years, because sufferers wasted away. Doctors adopted the modern name in the early 19th century after identifying the lung masses caused by the disease.

The now-popular use of acronyms also results from the speed of modern research. Researchers chose the name MERS-CoV because it communicates the suspected geographical origin of the virus (Middle East), the constellation of symptoms (respiratory syndrome), and the taxonomy of the pathogen responsible for the disease (coronavirus). There’s no way to cram that much information into three syllables without an acronym. Acronyms didn’t catch on until the early 20th century, though, so many of the world’s most famous diseases couldn’t have carried acronymic names, even if doctors had known enough about them to make a worthwhile acronym.

Got a question about today’s news? Ask the Explainer.

Explainer thanks Ben Zimmer, executive producer of the Visual Thesaurus and Vocabulary.com.

Brian Palmer writes about science, medicine, and the environment for Slate and the Natural Resources Defense Council. Email him at explainerbrian@gmail.com. Follow him on Twitter.

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