During my PhD, I spent years studying Ehrlichia japonica, a tick-borne bacterial pathogen that most people—including many physicians—have never heard of.😝
Whenever I explained my research to friends and family, the conversation sometimes followed this same script:
👀“How many people get infected?”
“Not many.”
👀“Is it a major public health problem?”
“Not really.”
👀“So why are you studying it?”
At the time, I answered with discussions about pathogen evolution, host-pathogen interactions, and the importance of understanding emerging infectious diseases. Looking back, I think there is a much simpler answer:
Because every pandemic begins as a disease that hardly anyone cares about.
Humans are remarkably inconsistent when it comes to risk assessment. We buy insurance for disasters that never happen. We wear seatbelts even though we expect to arrive safely. We back up our computers because we are terrified of losing old photos and tax documents. 💻
Yet when scientists point to a strange pathogen infecting a small number of people somewhere far away, our reaction is often surprisingly casual.
“If it’s so dangerous, why haven’t I heard of it?”
The flaw in this logic is that microbes do not care whether we have heard of them.
The World Health Organization maintains a list of pathogens with epidemic and pandemic potential. Many of the names are unfamiliar to the general public. Some cause only occasional outbreaks. Others remain confined to limited geographic regions.
WHO has even created a category called “Disease X”—a placeholder for a future pathogen that has not yet been discovered but could one day trigger a global health emergency.
If that sounds unsettling, it should.
Imagine boarding a plane and hearing the pilot announce:
“Good news, everything is functioning normally. Bad news, we have reserved a category called Plane Failure X for the catastrophic malfunction we haven’t discovered yet.” ✈️
Most passengers would probably prefer not to hear that.
Before 2020, SARS-CoV-2 was essentially scientific trivia. It was a cluster of unusual pneumonia cases that attracted little attention outside infectious disease circles. There were no documentaries about it. No endless social media debates. No family arguments during holiday dinners.
And definitely no nationwide toilet paper shortages. 🧻😂
Then, within a matter of months, it transformed healthcare systems, economies, education, travel, and daily life across the globe.
The most disruptive pandemic of modern times began as something that most people had never heard of.
This pattern is not unique to COVID-19. Ebola was once viewed primarily as a problem affecting remote communities. Zika spent decades in relative obscurity before becoming an international public health concern. Mpox remained largely outside public awareness until circumstances changed.
Again and again, humanity demonstrates a remarkable ability to underestimate microbes right up until they start interfering with vacation plans.
One of the biggest misconceptions about infectious diseases is the idea that rarity is a fixed property.
It isn’t.
“Rare” is often just a timestamp.
Every pandemic was once rare.
Every outbreak was once small.
Every disaster was once a situation that someone believed was under control.
If there is a phrase that should make epidemiologists (or me) nervous, it is probably:
“I don’t think this is going to be a big deal.”
Historically, those words have aged about as well as unrefrigerated milk.🙂
Another uncomfortable reality is that many so-called rare diseases are not actually rare at all. The World Health Organization estimates that neglected tropical diseases affect more than one billion people worldwide.
The word “neglected” is revealing.
These diseases are not neglected because they are biologically uninteresting. They are neglected because they disproportionately affect populations with less political influence, less media attention, and fewer resources.
To the people living with these diseases, there is nothing rare about them.
Pathogens, meanwhile, are benefiting from many of the same things that make modern life convenient. Climate change is expanding the habitats of disease-carrying ticks and mosquitoes. 🌎 International travel allows infected individuals to move between continents within hours. Urbanization creates new opportunities for transmission.
Human civilization has essentially spent centuries building the world’s most efficient microbial transportation network.
The microbes seem very appreciative.
One of the strangest realities of public health is that success often looks invisible.
When surveillance systems work, outbreaks are detected early and controlled.
When preparedness works, disasters never happen.
When prevention works, nothing makes the evening news.
When scientists spend ten years studying a pathogen that never becomes famous, people may reasonably wonder whether the effort was necessary at all.
Ironically, that is often the best possible outcome.
If your pathogen becomes a household name, chances are everyone is having a very bad year.
This creates a frustrating paradox. Society tends to reward responses to crises more than investments in preventing them. We celebrate firefighters after a building catches fire. 🚒
Nobody throws a parade for the smoke detector.
Yet the smoke detector may have done the more important job.
Public health operates under the same principle. Its greatest achievement is often the absence of catastrophe. The outbreaks that never happened. The epidemics that never spread. The pathogens that remained obscure because someone studied them before they became a problem.
As a former infectious disease researcher, I sometimes think back to those conversations about why anyone would spend years studying an obscure tick-borne bacterium.
Today, my answer is much shorter.
Somewhere in the world right now, there is a virus, bacterium, fungus, or parasite that most of us have never heard of.
Most people do not care about it.
Most governments are not prioritizing it.
Most journalists are not writing about it.
And if history has taught us anything, that is exactly the pathogen that worries me. 😅
Not because every obscure disease will cause the next pandemic.
But because every pandemic began as an obscure disease that somebody, somewhere, was trying very hard to convince everyone else was worth paying attention to.❤️
Why am I writing about obscure infectious diseases years after finishing my PhD? Honestly, because most people have hobbies, and apparently mine is reading about pathogens that sound like rejected Harry Potter spells. 😆Somewhere between work and life, I developed an unhealthy fascination with the tiny organisms constantly trying to outsmart us. Also, after dedicating several years of my life to studying a bacterium that absolutely nobody brought up at parties, I feel obligated to occasionally remind the world that I did, in fact, learn something. Consider this article my attempt to justify a significant portion of my twenties.👀