Flu pandemics and dengue fever among 'worst-case' health risks

Respiratory infections with pandemic potential pose greatest threat, but report spans seven themes from bloodborne and sexually transmitted to vector-borne 

The UKHSA has taken steps to future-proof the country against ‘worst-case scenarios’ when it comes to health risks.

The Agency published its first Health Security Risk Assessment in June, which stated that respiratory infections with pandemic potential pose the greatest risk to UK health security.

Emerging infections are also deemed a persistent and, in some cases, increasing threat, while the impact of antimicrobial resistance will be a key factor in other health risks in the coming years

Some of the UKHSA scenarios – involving a novel coronavirus pandemic, declining childhood immunisation coverage and extreme heat – will be very familiar, while others focus on the potential for known health threats to have a greater impact.

For example, under one scenario, a new strain of influenza arrives in the UK and over the course of two years leads to symptomatic infections in more than half of the UK population, 4% of whom require hospital care.

In another, a series of warmer-than-expected summers in continental Europe results in the Aedes albopictus mosquito becoming established in south-east England, leading to the first locally acquired cases of dengue fever in the UK, some requiring hospital care.

The report found recent incidents, such as outbreaks of Clade lb mpox, botulism, meningococcal B and hantavirus, also show ‘how rapidly health concerns can escalate’ and the need for effective strategic planning to safeguard the public’s health.

Professor Steven Riley, UKHSA Chief Data Officer, said the report would “enhance our preparedness measures and resilience planning” with regard to health security risks, particularly as they “disproportionately impact more vulnerable groups in our society”.

He said it reflected the breadth of UKHSA’s remit in responding to threats but was also designed to support partners in government, health services and other public and private services, who had collaborated extensively on the report to ensure its relevance and rigour.

Professor Riley added, “While respiratory infections with pandemic potential remain our greatest threat, the health hazards in this report span seven themes: bloodborne and sexually transmitted, contact, gastrointestinal, respiratory, vector-borne, environmental and combined events.”

“As much as we can plan for the major risks – and it’s helpful to plan and prepare – we also have to have humility that sometimes we don’t have a crystal ball…”

Devi Sridhar, Professor of Global Public Health at the University of Edinburgh, said: “It’s useful to have this type of overview of the various types of threats over the next five years and an understanding of where we’re at in terms of impact and how it might fall.”

But she warned the UK must also be on the lookout for the unexpected, as “the only certainty is that there’s always uncertainty about virtual evolution.

“As much as we can plan for the major risks – and it’s helpful to plan and prepare – we also have to have humility that sometimes we don’t have a crystal ball and simply don’t know what the main risk to emerge will be,” said Professor Sridhar.

“We just have to build systems and institutions that can adapt to the specific outbreak or risk, and platforms that mean medical countermeasures can be created, approved and manufactured rapidly.”