In 2018, the WHO introduced Disease X to its list of blueprint priority diseases. This was a forward-thinking decision, acknowledging the limitations of our knowledge in the "microbial soup" of our environment. Disease X was not merely a theoretical construct but a recognition that an unknown pathogen could emerge and disrupt global health systems.

"Disease X" has now become a rude reminder of human fragility. The World Health Organization (WHO) coined this term in 2018. Disease X, an unknown pathogen, may trigger a global pandemic. Such a hypothetical but alarmingly real concept is calling out to the governments, researchers, and health organizations to be prepared for anything.

Fast-forward to December 2024 a mysterious disease swept through the Panzi district in the Democratic Republic of Congo, killing 48 people. Fever, fatigue, and respiratory distress were the presenting features. Dubbed Disease X by the Africa Centers for Disease Control and Prevention, the outbreak is an important lesson in early detection and swift response to unknown diseases. Subsequent analysis identified familiar pathogens and contributory factors, such as malnutrition and malaria.

What is Disease X?

Disease X is not attributed to any particular pathogen but is instead a placeholder for a future virus or bacteria with pandemic potential. Symptoms of Disease X are theoretical, but can be assumed as fever, respiratory distress, and gastrointestinal issues from previous outbreaks.

Possible Causes of Disease X

Zoonotic Spillovers: The transfer of pathogens from animals to humans, which is often worsened by deforestation and wildlife trade.

Antimicrobial Resistance: Overuse of antibiotics has led to the development of drug-resistant strains, which reduces the effectiveness of treatment.

Climate Change: Changing temperatures create conditions for new diseases to emerge and spread.

Globalization: Increased human mobility facilitates the rapid spread of pathogens across borders.

Historically, influenza and coronaviruses have proven their capability to cause a global health crisis. The recent swine flu pandemic in 2009 and the current outbreak of COVID-19 are good examples of unpredictable viral mutations and zoonotic transmission.

Past research into related pathogens has been extremely useful. For example, previous work on MERS and the coronavirus spike protein greatly expedited the production of COVID-19 vaccines. This underscores the need for proactive research into viral families with pandemic potential, including flaviviruses and coronaviruses.

Also Read: What Is COVID XEC Variant, The Strain That Is Spreading Fast In The West?

Preparing for the Unknowns of Disease X

The global response to Disease X must be multifaceted:

• Strengthening Surveillance Systems: Strong global monitoring networks will be able to detect outbreaks early, thus providing timely interventions.
• Investing in Flexible Vaccines: Advances in mRNA technology offer adaptable platforms for rapid vaccine development.
• Public Health Infrastructure: Building resilient healthcare systems capable of managing large-scale health crises.
• International Collaboration: Partnerships across nations can pool resources and expertise for effective responses.
• Public Awareness: Hygiene practices, vaccinations, and education are critical in mitigating disease spread.

Lessons from the Congo Outbreak

The outbreak in the Congo stands as a case study in working through the complexities of unknown diseases. While the area was very remote and presented a complex web of overlapping health issues, rapid deployment of health experts underscored the importance of preparedness, but also the gaps in infrastructure and logistical capabilities, which again underlined a need for much greater investment in global health systems.

Including Disease X in the WHO blueprint means shifting to proactionist health strategies. It's all about doing more work in researching prototype pathogens like flaviviruses and coronaviruses so as to prepare against the pandemics of the future. In a similar light, the US National Institute of Allergy and Infectious Diseases has been actively contributing, working to develop vaccines and therapies for major virus families and adapting to changes very fast once the threats surface.

Disease X is a cautionary tale, not a cause for panic. It is nature's unpredictability and the urgent need for preparedness. Governments, health organizations, and individuals must unite to strengthen surveillance systems, invest in research, and foster global cooperation.

As we move about in a world full of microbiological threats, the lessons of previous pandemics and foresight in initiatives like Disease X point the way to resilience. It simply depends upon the understanding that while we cannot predict anything in life, we can prepare for it.

Disclaimer: This article is for informational purposes only. Consult a healthcare professional for personalized medical advice.

Prototype pathogen approach for pandemic preparedness: world on fire. JCI. 2020

First list of top emerging diseases likely to cause major epidemics. WHO. 2015

When the pregnancy test turns positive, a flood of excitement, anticipation, and in many cases, anxiety sets in—not only for the mother-to-be, but also for her partner. When all eyes usually remain on the pregnant woman's body and mood, new research and anecdotal evidence are revealing an unexpected phenomenon: expectant fathers can experience physical and psychological changes that resemble pregnancy symptoms. This is a real phenomenon, referred to as Couvade Syndrome or sympathetic pregnancy—something that isn't imagined, but a valid and multifaceted reaction that's gaining international acclaim.

What Is Couvade Syndrome?

Couvade Syndrome is named from the French term couver, which means "to brood" or "incubate." It is a disorder where men develop pregnancy-like symptoms as their partner is pregnant. These symptoms start in the first trimester, decrease in the second trimester, and then show up again in the third trimester—tightly following the path of the mother.

Though not technically classified as a medical or psychological illness, Couvade Syndrome has been noted through various cultures and societies. In certain tribal rituals of old, men would ritually perform labor to show support for their mate—a ritualistic forerunner to the psychosomatic phenomenon now clinically debated as an empathetic, stress-related, or hormonal response.

Physical and Emotional Symptoms of Couvade Syndrome

Think it's all in their minds? Think again. Pregnant men with Couvade Syndrome describe a remarkable array of physical and mental symptoms:

Nausea and vomiting: A surprising similarity to morning sickness

Gastrointestinal problems: Bloating, stomach cramps, diarrhea or constipation

Changes in appetite and weight: Some put on weight (aka "sympathy weight"), others can lose their appetite completely

Sleep problems and fatigue: Insomnia or constant drowsiness

Back pain and leg cramps

Toothaches and skin rashes

Mood swings, irritability, anxiety and depression

Up to 38% of expectant fathers, or the first-time father in one international study, experienced over 19 symptoms when they found out that their partner was pregnant. The reasons are not certain yet but the most commonly accepted theories are psychosomatic reactions, hormonal changes (such as reduced testosterone and increased prolactin), and psychological mechanisms like "compathy," shared pain or emotional distress.

Is Couvade Syndrome Common?

Surprisingly, yes—more than you might have guessed. Incidence rates of Couvade syndrome also differ widely based on the nation and study criteria, from 11% up to a whopping 65% worldwide. In the United States alone, estimates suggest that between 25% to 97% of expectant fathers could experience it. The rate in Poland is as high as 72%, with the United Kingdom and Australia reporting lower rates, at between 25% and 31%. Other nations, such as Sweden, Thailand, and China, also register considerable prevalence. These differences indicate that although the phenomenon may be subjective and culturally influenced, sympathetic pregnancy is certainly no rarity.

What Causes Couvade Syndrome?

The scientific community hasn't yet determined a single determining cause of Couvade syndrome, but some of the most current theories provide interesting explanations. One explanation is empathy and emotional attachment—men who are strongly bonded to their pregnant partner might unconsciously pick up and mirror their partner's bodily stress. Hormonal changes have also been found, with research reporting decreased testosterone and raised levels of prolactin and cortisol in some prospective fathers, which can cause mood swings, lethargy, or other physical symptoms. Stress and anxiety, especially for first-time dads, can also be a factor, with the prospect of new responsibility bearing down on them physically. Also, shifting psychosocial expectations of fatherhood could be a factor. As social norms change and promote more engaged, emotionally responsive parenting, men might internalize and replicate facets of pregnancy more strongly than generations past.

Dads today are not hanging back in the wings anymore. From attending prenatal visits to taking birthing classes and carrying out skin-to-skin contact after birth, contemporary dads are actively involved. This greater engagement may be amplifying their emotional and physiological identification with pregnancy, a component of couvade symptoms' prevalence.

Anthropologists consider that this change is a development of classic gender roles and possibly the reason couvade syndrome is reported more often today than in earlier generations.

Coping with and Managing Couvade Symptoms

There is no official treatment of Couvade Syndrome, but there are methods that can ease it:

Stay informed: Taking prenatal classes and reading parenting books can prepare expectant fathers better.

Communicate: Have open talks with your partner concerning your feelings and physical changes. You can be met with mutual understanding instead of confusion or dismissal.

Consult professionals: If symptoms become a cause of distress, talking to a psychologist or a medical doctor can provide insight and ways of coping.

Practice self-care: Regular exercise, meditation, and proper nutrition can help in coping with stress-related symptoms.

Lean on your support network: Don't be afraid to call on friends, family, or online networks of expectant dads.

While it is common, couvade syndrome usually goes unnoticed—dismissed as strange, overblown, or even manipulative behavior but defined as a real psychosomatic experience can affirm expectant dads and open the door to more honest, supportive dialogue throughout pregnancy.

Understanding that pregnancy impacts both partners—though differently—can promote mutual compassion, enhance communication, and cultivate deeper emotional connections on one of life's most transcendent paths.

Pregnancy could be an experience shared in ways we never thought possible. Couvade Syndrome, although yet to be fully comprehended, highlights the depth of emotion and changing role of modern dads.

In recent months, a wave of concern has rippled through the U.S. public health community over a so-called “cognitive supplement” that’s been quietly—and dangerously slipping into the hands of consumers. Marketed with appealing names and colorful packaging, often sold at gas stations, smoke shops, and corner stores, these energy-boosting elixirs and mood enhancers are anything but benign. They contain tianeptine, an unapproved drug in the United States that’s quickly earning notoriety under the alarming nickname “gas station heroin.”

With a growing number of emergency calls, FDA warnings, and unregulated formulations circulating under the radar, tianeptine has become a chemical wildcard posing significant risks to public health while masquerading as an over-the-counter supplement.

What Is Tianeptine?

Tianeptine is a tricyclic antidepressant originally developed and approved for use in several European, Asian, and Latin American countries to treat conditions like major depressive disorder, anxiety, and even irritable bowel syndrome. Despite these approved medical uses abroad, tianeptine has never received approval from the U.S. Food and Drug Administration (FDA) for any therapeutic purpose.

What’s particularly alarming is the way this compound is being sold in the U.S.—not as a regulated pharmaceutical, but as an unregulated cognitive enhancer or energy booster, available under brand names such as Zaza, Tianna, Pegasus, TD Red, and Neptune’s Fix. These products are packaged to resemble energy drinks or wellness shots, creating a false sense of safety for unsuspecting buyers.

How Tianeptine Is Slipping Through the Regulatory Cracks

Tianeptine’s entry into the U.S. market exploits a regulatory loophole. The FDA doesn’t preapprove ingredients used in supplements before they hit store shelves. As a result, many companies are selling tianeptine-based products under the guise of dietary supplements, despite explicit warnings from the FDA stating that tianeptine cannot legally be added to food, beverages, or supplements.

“It’s kind of this grey area of consumer products,” explains Dr. Diane Calello, medical director of the New Jersey Poison Information and Education System. “These products are not tested or regulated in the same way that medications are.”

This grey area is not without consequences. A recent study led by Calello documented a cluster of emergency cases in New Jersey, where individuals experienced symptoms such as rapid heartbeat, seizures, and low blood pressure after consuming a tianeptine-laced beverage called Neptune’s Fix. Of the 20 patients, more than half were admitted to intensive care units.

Why Are People Using Gas Station Heroin?

Tianeptine’s appeal lies in its opioid-like effects, even though it is not classified as an opioid. The drug interacts with mu-opioid receptors in the brain, producing short-term euphoria, pain relief, and mood elevation. These effects are similar to those of controlled narcotics like oxycodone—but without the same legal restrictions.

Some products claim, without clinical backing, that tianeptine can treat addiction, anxiety, depression, and even sexual dysfunction. In 2018, the FDA issued a warning letter to the makers of Tianna, a supplement that claimed to offer a solution to opioid cravings—another red flag in a market already marred by misinformation.

But the pursuit of relief comes at a price. Many users increase their dosage over time, either to self-treat withdrawal symptoms or to chase a high. High doses can cause severe respiratory depression, the same life-threatening condition caused by opioid overdoses. And unlike regulated medications, there’s no standardization in these products, making them even more dangerous.

What are The Risks And Side Effects of Using Tianeptine?

Even in small doses, tianeptine is not without risk. Reported side effects include:

• Nausea and vomiting
• Dizziness and drowsiness
• Constipation
• Abdominal discomfort
• Bad dreams
• Headaches
• Dry mouth

However, when misused or taken in large amounts—especially in combination with substances like alcohol, opioids, or stimulants—tianeptine can lead to cardiac arrest, seizures, or even death.

Moreover, regular users may find themselves battling withdrawal symptoms similar to those experienced during opioid withdrawal. These can include:

• Agitation and anxiety
• Muscle pain and sweating
• Depression
• Chills and trembling

Withdrawal begins quickly and can be intense, reinforcing the cycle of dependence.

The FDA and U.S. poison control centers have issued repeated alerts, cautioning the public and health professionals about the growing number of adverse events linked to tianeptine.

Last month, the FDA took a firmer stance, warning healthcare providers about “the magnitude of the underlying danger of these products.” Poison control centers across the country have seen a steady uptick in calls involving tianeptine-related overdoses, particularly among individuals with a history of substance use or mental health issues.

Despite these warnings, tianeptine remains accessible in many gas stations and smoke shops, often labeled misleadingly as a natural mood enhancer or energy booster. This underscores the need for stronger regulations and consumer awareness campaigns.

If you or someone you know is experiencing depression, anxiety, addiction, or chronic pain, consult a licensed medical professional for FDA-approved treatments. There are safe and effective therapies available—including medications and cognitive behavioral therapy—that have been rigorously tested and regulated.

Avoid purchasing any so-called “cognitive supplements” or energy drinks from gas stations or smoke shops, especially those that are vaguely labeled or make unverified medical claims.

If you suspect someone is experiencing an overdose or withdrawal from tianeptine, contact emergency medical services immediately.

What’s marketed as a quick fix in a flashy bottle may actually be a dangerous and addictive drug. As the story of gas station heroin unfolds, it’s clear that consumers need to be vigilant, and regulators must act faster to protect public health.

The global ambition to end AIDS as a public health threat by 2030 is now more uncertain than ever. Winnie Byanyima, Executive Director of UNAIDS, has warned that funding cuts introduced under former U.S. President Donald Trump will further derail progress on HIV/AIDS prevention and treatment. Speaking to journalists in Johannesburg, South Africa, Byanyima described the situation as “already off track,” citing the latest data that showed 1.3 million new HIV infections worldwide in 2023.

South Africa, which has the highest number of people living with HIV—around 8 million—was the backdrop for Byanyima's meeting with President Cyril Ramaphosa. Their discussion focused on how to sustain Africa’s HIV/AIDS response in light of major reductions in U.S. foreign aid, historically one of the region’s largest funding sources.

Ripple Effects Across Africa

Byanyima expressed concern over the growing impact of the funding cuts, particularly on local health systems. “Less funding means we will get more and more off-track,” she said, noting that the exact consequences remain to be seen. However, early signs are troubling: several countries have reported a decline in the number of people visiting clinics.

Previously, prevention programmes supported by foreign aid—especially those funded through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)—had helped bring down infection rates. But the rate of decline wasn’t fast enough, Byanyima explained. With reduced funding now shuttering community clinics across Africa, she warned that infection rates could begin to rise again, although exact projections are unclear.

Treatment Supply Under Threat

The cuts have also created disruptions in the supply of critical antiretroviral drugs, which are essential for managing HIV. In some regions, countries are now at risk of running out of these life-saving treatments. South Africa, which relied on the United States for around 20% of its HIV budget, has already begun to experience the fallout. Testing and patient monitoring have seen a measurable decline.

Despite the challenging financial landscape, some low-income and heavily indebted countries are attempting to bridge the gap with their own limited resources. However, Byanyima emphasized that this approach is not sustainable and urged wealthier nations to step up.

"Don’t Stop Now"

Calling on global donors to renew their commitment, Byanyima argued that progress on HIV/AIDS is within reach—and that pulling back now would be a mistake. “This is one of the diseases without a cure, without a vaccine, yet we’re seeing progress,” she said. “If you’ve got a good success story, why drop it before you end it?”

Byanyima’s message was clear: while efforts have borne fruit, the world must not lose momentum. If the goal of ending AIDS by 2030 is to be achieved, urgent international cooperation and sustained investment will be critical.