Understanding the Introduction of Pathogens into Humans: Preventing Patient Zero: Proceedings of a Workshop (2026)
Chapter: 1 Introduction
1
Introduction
While pandemics like the COVID-19 outbreak used to be considered once-in-a-century events, there is growing evidence that changing conditions on the planet may result in greater frequency of disease events. Daniel Bausch, National University of Singapore, opened the workshop by noting that every outbreak begins with a single human infection. Devastating downstream effects of a spillover—that is, transmission of a pathogen from one species to another—might be avoided if this initial infection could be prevented. A holistic understanding of routes of pathogen emergence and transmission is crucial for prevention and mitigation efforts, he said. Bausch noted that human interactions with animals, such as in agriculture settings or through direct interaction with wildlife, pose a risk of pathogen spillover. He added that laboratory biosafety and biosecurity are critical to ensuring that pathogens are contained and do not infect humans, either accidentally or intentionally. Despite the advances in research on how infectious diseases spread, there remain gaps in understanding when it comes to the specific drivers and mechanisms of pathogen transmission at the animal–human interface.
WORKSHOP OBJECTIVE
A planning committee under the auspices of the Forum on Microbial Threats organized a public workshop on January 15 and 16, 2025, titled “Understanding the Introduction of Pathogens into Humans—Preventing Patient Zero.” The objective of the workshop was to examine current knowledge in understanding the emergence of diseases with pandemic potential,
highlight evidence gaps, and discuss actionable research to address these gaps toward improving the prevention of—and rapid response to—disease emergence events (see Box 1-1). Attendees at the workshop explored persistent unknowns in the understanding and prevention of disease emergence at the animal–human interface, including but not limited to wildlife-to-human spillover, and they discussed how to address these gaps while safeguarding biosafety and biosecurity in laboratory and field research.
BOX 1-1
Workshop Statement of Task
A planning committee of the National Academies of Sciences, Engineering, and Medicine will organize a public workshop to examine current knowledge in understanding emergence of diseases with pandemic potential at the animal-human interface, highlight evidence gaps, and discuss actionable research to address these gaps and improve prevention of and rapid response to disease spillover events.
The first part of the workshop will explore gaps in the understanding and prevention of disease emergence at the animal-human interface, including but not limited to wildlife-to-human spillover. The second part of the workshop will discuss how to address these gaps while safeguarding biosafety and biosecurity in the laboratory and in the field. Speakers may address the following:
- Historical context, existing evidence, and ongoing research on drivers of zoonotic disease spillover, including but not limited to routes such as animal trade, hunting, and the production of animals for food and other animal-derived goods;
- Known and potential mechanisms for natural spillover of zoonotic pathogens from animals to people in these different settings and implications for future research priorities;
- Scientific unknowns in understanding of animal-human transmission routes, including limitations of public health decision-making and rapid response efforts due to these knowledge gaps;
- Known and potential risks for unintended zoonotic pathogen infection in conducting field or laboratory research to advance understanding of disease spillover, including gaps and uncertainties in understanding adherence to existing biosafety standards, data reporting for deviations, and adapting policies and practices to emerging or high-consequence pathogens;
- Potential solutions to address knowledge gaps in understanding animal-human transmission routes for diseases with pandemic potential while minimizing unintentional biosafety and biosecurity risks;
- Engagement of stakeholders or resources that have not been well-represented in outbreak preparedness efforts thus far but may hold important missing knowledge in disease emergence and transmission chain from animals to humans;
- Barriers and enablers in aligning public health needs, policy decisions, and research goals in resource allocations, balancing competing priorities, and engaging necessary stakeholders to address these knowledge gaps.
The planning committee will develop the agenda, select speakers and discussants, and moderate or identify moderators for the discussions. A proceedings publication that summarizes the presentations and discussions held during this workshop will be prepared by a designated rapporteur in accordance with institutional guidelines.
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