Infectious disease expert Dr. Dave Wessner explains how infectious diseases get their names, and why using those names properly is an important aspect of fighting them.
The viruses have official names: SARS-CoV-2 and HIV. The associated diseases also have official names: Covid-19 and AIDS. For both pandemics, these names arose via a deliberate process involving input from an international array of researchers and clinicians. One could reasonably ask if this naming process matters. After all, when the world is in the midst of a pandemic, taking time to officially name a disease may seem unnecessary.
But names matter. Words matter.
When the U.S. news media first began reporting on the current pandemic, the names used to describe the virus were varied, but typically linked the it to a place. The Chinese coronavirus. The Wuhan virus. Other, more derogatory names also were, and unfortunately still are, used by some. These names reflected the fear associated with the virus and how little was known about it. Quickly, though, official names were proposed. On 11 February 2020, the International Committee on Taxonomy of Viruses (ICTV) announced that the novel coronavirus would be named SARS-CoV-2. On that same day, the World Health Organization (WHO) announced that the disease caused by this virus would be named Covid-19.
The official naming of HIV/AIDS followed a somewhat similar pattern. In 1981, when reports of this syndrome first appeared in the scientific literature, the popular press and the general public quickly tied the disease to men who have sex with men, using names like gay cancer and gay-related immune deficiency, or GRID. Soon after, connections were drawn to the so-called 4 Hs; homosexuals, heroin users, Haitians, and hemophiliacs. Again, the names reflected the fear of the public and a lack of concrete scientific information. It wasn’t until September 1982 that the CDC first used the current name for the disease, acquired immunodeficiency syndrome (originally immune deficiency), or AIDS. Nearly four years later, the ICTV proposed an official name for the virus, human immunodeficiency virus, or HIV.
How are the names of new infectious diseases determined?
In 2015, the World Health Organization proposed general guidelines for naming newly recognized human infectious diseases. According to their statement, “a disease name should consist of generic descriptive terms…and more specific descriptive terms,” if such information is known. Additionally, the name of the pathogen also could be included. More importantly, the disease name should not include references to geographic locations, specific cultures or populations, occupations, or people’s names. These best practices, the WHO statement notes, “minimize unnecessary negative effects on nations, economies, and people.”
To name viruses, the ICTV uses a slightly different approach. Again, the use of people’s names, geographic locations, and cultural references are discouraged. Rather, the name of a newly recognized virus should reflect its genetic relationship to previously categorized viruses.
Sequence analysis revealed that the virus associated with the current pandemic is within the coronavirus family of viruses. More specifically, it is closely related to, but genetically distinct from, SARS-CoV, the virus identified in 2003 that causes SARS, or severe acute respiratory syndrome. Hence, the novel virus has been named SARS-CoV-2. Because a member of the coronavirus family causes the current pandemic disease, and because the disease first was reported in 2019, the disease has been named Covid-19. For HIV/AIDS, the names of the virus and associated syndrome both reflect the defining outcome of infection, immunodeficiency.
How we name infectious diseases matters. How we use those names matters, too.
For both HIV/AIDS and SARS-CoV-2/Covid-19, the unofficial names stigmatize marginalized groups and fuel feelings of xenophobia. Verbal and physical attacks on men who have sex with men, transgender people, sex workers, and other marginalized groups have been well-documented throughout the AIDS pandemic. Similarly, we have seen increased rates of violence toward people of Asian descent in the United States since the beginning of the current pandemic. Of course, this form of stigma is not unique to these two pandemics. As Susan Sontag wrote in AIDS and Its Metaphors, “A polluting person is always wrong…[and] a person judged to be wrong is regarded as, at least potentially, a source of pollution.”
Linking an infectious disease with a certain group of people has consequences.
At the conclusion of the recent AIDS 2020 conference, Dr. Adeeba Kamarulzaman, president of the International AIDS Society, stated about HIV/AIDS, “…stigma and discrimination is still one of the biggest threats we face.” How we talk about pandemics like HIV/AIDS and Covid-19 can contribute to and perpetuate stigma. And continued stigmatization only inhibits our ability to combat the pandemics.
How we name infectious diseases matters. How we use names matters, too.