From 2000 to 2022, pandemic pathogens such as SARS-CoV-2, the virus that causes COVID-19, imposed the largest historical and projected emerging infectious disease (EID) burdens around the world, while dengue and cholera were the most burdensome non-pandemic illnesses, suggests a new analysis in BMJ Global Health.

By region, the Americas and Africa shouldered the largest per-capita burdens, and the Western Pacific faced the smallest.

Led by Harvard researchers, the study team developed a method for measuring and ranking health and economic disease burdens and applied it to 15 high-priority EIDs in 223 countries and territories historically (2000 to 2022) and prospectively (2025 to 2034). 

Health burdens consisted of disability-adjusted life-year losses, converted into monetary values using the value of a statistical life-year. Economic burdens consisted of direct and indirect costs during acute illness for hospitalized patients. 

“While many studies have reported the health burdens of individual diseases, … their varying methodologies make disease comparisons difficult,” the researchers wrote. 

Disease burdens key to R&D prioritization

COVID-19 had the largest weighted full burden globally ($63.3 trillion) and across all world regions except Africa, where cholera posed a greater burden. 

R&D [research and development] priority-setting, including MCM [medical countermeasures] development, depends on multiple criteria, including disease burdens.

The EIDs with the next-largest burdens were cholera, dengue, and pandemic H1N1 influenza, whose full weighted costs were $12.2 trillion, $8.0 trillion, and $4.4 trillion, respectively. 

Significantly smaller full burdens were West Nile virus, at $18.8 billion, and Ebola, at a weighted full burden of $93.2 billion. All other EIDs had weighted full burdens at less than $8 billion.

In the United States, pandemic H1N1 made up the second-highest full burden ($235.1 billion), followed by West Nile ($18.2 billion).

“R&D [research and development] priority-setting, including MCM [medical countermeasures] development, depends on multiple criteria, including disease burdens,” the authors concluded. “Our full burden quantification methods and results, along with other such criteria, can inform priority-setting.”

A coalition of 65 health, environmental, consumer, and animal welfare groups has filed a petition with the US Food and Drug Administration (FDA) to end the routine use of antibiotics in food-producing animals.

The citizen’s petition, sent last week to the FDA, calls on the agency to withdraw approval of medically important antibiotics that are administered in animal feed and water when not associated with a diagnosed illness. The target of the petition is use of antibiotics for disease prevention and “maintenance of growth” in poultry, swine, dairy cattle, and beef cattle—uses the groups argue are unnecessary and contribute to the emergence and spread of antibiotic-resistant bacteria. 

The Centers for Disease Control and Prevention estimates that drug-resistant bacteria contribute to about 35,000 deaths and 2.8 million infections in the United States each year. Many of the antibiotics used in food-producing animals are also used in people.

An estimated 34 million pounds of antibiotics are used in livestock water and feed in the United States each year, according to the petition. While antibiotics are necessary for treating animals that have diagnosed bacterial infections, antibiotic stewardship advocates have long argued that the FDA should do more to prevent overuse of the drugs in food-animal production. The agency has banned the use of antibiotics for growth promotion but still allows use for disease prevention in otherwise healthy animals.

Routine antibiotic use ‘fueling a resistance crisis’

The petition argues that, under the Federal Food, Drug, and Cosmetic Act, the FDA is obligated to withdraw approval for disease prevention uses and long-duration administration of medically important antibiotics in animals because those uses may pose a harm to human and animal health.

“Antibiotics are still being used in livestock as a matter of routine rather than to treat diagnosed diseases—fueling a resistance crisis that puts our health at risk,” Consumer Reports senior scientist Michael Hansen, PhD, said in a press release. “The FDA has both the tools and the obligation to act.”

The groups also want the FDA to mandate collection of species- and sector-specific antibiotic use data from US farms, and to set reduction targets for antibiotic use by livestock sector.

• Three more cattle and one goat have New World screwworm infections, according to the latest update from the US Department of Agriculture’s Animal and Plant Health Inspection Service. There are now 19 total detections in the United States, all but one in Texas. The infection is caused by parasitic fly larvae that feed on the tissue of living animals. Since 2024, Mexico has been battling the increasing activity of the pest. The four most recent cases were all detected in Terrell County, Texas.
• The Centers for Disease Control and Prevention (CDC) has planned to phase out federal diagnostic testing for measles and mumps, according to Politico. The CDC said the option is not needed, and the agency has performed only four diagnostic measles tests in 2026, and 46 tests in all of 2025. The CDC did not share how many mumps tests it had performed in recent years. State labs have taken on the brunt of diagnostic testing as the nation has faced a resurgence of measles in the past two years.
• The CDC today officially ended its hantavirus outbreak response. None of the 18 Americans who were aboard a Dutch cruise ship in April and May were sickened during the outbreak or the following 42-day incubation period which ended earlier this week. “The successful conclusion of this response demonstrates the strength of a coordinated response to infectious disease threats that occur outside of our borders,” said CDC acting Director Jay Bhattacharya, MD, PhD, in a statement. “I am grateful for the world-class team at CDC whose dedication and swift action helped identify potential exposures, provide clear guidance, and protect the American people. As a result, we prevented any new cases from arising in the U.S.”