Understanding Toponymous Diseases
Toponymous diseases derive their names from geographical locations, such as towns, rivers, islands, forests, countries, or continents. Examples include:
- Spanish flu
- Delhi boil
- Madura foot
- West Nile Virus
However, such names often lead to misinformation, stigma, and racial prejudice. They can politicize science and unfairly tarnish entire nations or communities, especially when the true origins of the disease remain unclear.
The Case of the Spanish Flu
- The 1918–1920 influenza pandemic was labeled the Spanish flu, despite not originating in Spain.
- Reason for the misnomer:
- Spain was neutral during World War I and did not censor reports on the outbreak.
- Other countries, involved in the war, suppressed news to avoid lowering morale.
- As a result, the pandemic, which affected 500 million people and caused over 20 million deaths, was inaccurately associated with Spain.
The Shift Towards Scientific Naming
Recognizing the harmful effects of geographical disease names, the World Health Organization (WHO) took action in 2015. It urged scientists to use names based on scientific characteristics rather than location.
Examples of Renaming Diseases
- Congenital Zika Syndrome (2016)
- The Zika virus was named after the Zika Forest in Uganda, where it was first isolated.
- To avoid geographical stigma, the WHO recommended the term Congenital Zika Syndrome to describe the fetal condition caused by the virus.
- Mpox (Monkeypox) – 2022
- The WHO renamed monkeypox as mpox due to concerns over racist and stigmatizing language linked to the disease’s name.
The Controversy Over Trichophyton indotineae
Despite WHO guidelines, misleading disease naming continues. A recent example is the fungal species Trichophyton (T.) indotineae, which causes widespread skin infections resistant to antifungal treatments.
Why the Name is Problematic
- The term ‘indotineae’ unfairly links the disease to India and South Asia, even though its origin remains uncertain.
- The fungus has been reported in over 40 countries.
- The Japanese dermatologists who first identified it in Indian and Nepali patients proposed the name, ignoring WHO recommendations.
- Indian medical experts objected, publishing an article in the Indian Journal of Dermatology, Venereology, and Leprology, arguing that the name is inaccurate and prejudicial.
Scientific Concerns
- The fungus causes ringworm and is resistant to terbinafine, a key antifungal drug.
- Research on the resistance gene was first conducted in India by:
- Dr. Ram Manohar Lohia Hospital, Delhi
- Postgraduate Institute of Medical Education and Research, Chandigarh
- Misleading names do not aid in treatment or research but can fuel discrimination.
The WHO’s Role in Disease Naming
The WHO is responsible for assigning names under the International Classification of Diseases (ICD). Key naming principles include:
- Scientific accuracy
- Ease of pronunciation
- Avoidance of geographical or zoological references
- Consideration of current usage and historical relevance
Correcting Past Mistakes: The Case of Reiter’s Syndrome
- Previously named after Hans Reiter, a German physician who described reactive arthritis in 1916.
- Post-World War II, Reiter was exposed as a Nazi involved in unethical medical experiments.
- The syndrome was renamed reactive arthritis to remove association with his legacy.
The Need for Precision and Unity
Lessons from COVID-19
The SARS-CoV-2 pandemic underscored the global interconnectedness of health crises. It reinforced the need to:
- Focus on scientific accuracy rather than stereotypical labels.
- Promote collaborative global research instead of politicization.
A Call to Action
- The WHO and global scientific communities must prioritize accurate, neutral disease naming.
- Naming should be rooted in science, not assumptions, stigma, or nationalism.
- Microbes do not recognize borders, and disease prevention should unite rather than divide people.
Toponymous disease names mislead, stigmatize, and create unnecessary divisions. The WHO’s push for scientific, neutral naming is crucial in ensuring global cooperation, accurate disease tracking, and effective medical responses. By choosing precision over prejudice, the scientific community can foster a more inclusive and responsible approach to public health.
