Who gets to name all these new diseases we’re exposed to?

Brian Palmer / Slate /

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 recently 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.

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.