Recently, experts opposed naming Trichophyton indotineae, citing regional bias. This highlights ongoing challenges in neutral disease naming.

Toponymous Diseases

• About: Toponymous diseases derive their names from geographical locations, such as: Towns, rivers, islands, forests, mountains, valleys, countries, continents, and trenches.
  • Examples include: Spanish flu, Delhi boil, Madura foot, and West Nile Virus.
• Stigma: Naming diseases after locations often leads to misinformation, stigma, and racial prejudice. It can politicize science and unfairly tarnish entire regions and populations.
• Spanish Flu: The 1918-1920 influenza pandemic is commonly called the Spanish flu, though Spain was not its origin.
• Misnomer: Spain remained neutral in World War I, unlike other countries that censored news about the flu to maintain morale.
  • The Spanish media freely reported on the pandemic, leading to the false perception that the disease originated there.
• Global Impact: The pandemic affected 500 million people worldwide. It caused more than 20 million deaths.

Efforts to Address Misleading Disease Names

• WHO’s Initiative:  In 2015, the World Health Organization (WHO) took a significant step to prevent the stigmatization associated with toponymous disease names.
• Basis: WHO mandated that diseases should be named based on scientific characteristics, rather than geography.
• Zika Syndrome: The Zika virus was first identified in 1947 in a rhesus monkey in the Zika forest, Uganda while researching yellow fever. 
  • The virus was named after the forest in the Luganda language.
• Renaming by WHO: In 2016, WHO renamed the fetal disease linked to Zika virus as Congenital Zika Syndrome, to reflect its scientific basis rather than its geographical association.
  • Mpox (Monkeypox): In response to reports of racist and stigmatizing language, WHO renamed “Monkeypox” to Mpox. 
  • The decision aimed to prevent discrimination against certain communities and regions both online and offline.

Challenges in Disease Naming

• Misleading Nomenclature: Despite WHO’s guidelines, region-specific disease naming still persists. 
  • In January 2024, dermatologists from India and 13 other countries raised objections against the naming of a novel fungus species—Trichophyton (T.) indotineae. 
  • The name “indotineae” carries pejorative connotations and unfairly links the disease to a specific region.
• Impact of Trichophyton Indotineae: The fungus causes a common skin infection known as ringworm. It is resistant to the first-line oral antifungal drug, terbinafine.
  • Origin: The resistance gene was identified by Dr. Ram Manohar Lohia Hospital and the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh.
• Global Spread: Japanese dermatologists first identified the fungus in patients from India and Nepal in 2020. The actual origin of the fungus remains unknown, yet it has been reported in more than 40 countries.
• Violation of recommendations: Experts argue that the name is prejudicial and violates WHO’s recommendations.
  • An article in the Indian Journal of Dermatology, Venereology, and Leprology titled “Trichophyton indotineae is an inaccurate and pejorative term” highlights these concerns.
• Requirement: WHO’s disease naming framework requires:
  • Scientific appropriateness
  • Absence of geographical or zoological references
  • Ease of retrieval of historical scientific information

Way Forward

• WHO’s Role: WHO holds the authority to assign names to new and existing diseases under the International Classification of Diseases. WHO has renamed diseases linked to problematic legacies:
• • Reiter’s Syndrome (named after Hans Reiter, a Nazi-affiliated physician) was renamed as Reactive Arthritis.
• Unified Approach: WHO and scientists worldwide must focus on identifying disease causes and developing preventive measures. 
  • Disease naming should be precise, neutral, and based on scientific characteristics, avoiding geographical or cultural bias.
• Lessons from SARS-CoV-2 The COVID-19 pandemic reinforced that diseases do not respect borders. A global response is essential to effectively control outbreaks and minimize misinformation.
• Unity and Sensitivity: Scientific integrity should guide naming conventions, ensuring they do not stigmatize specific regions or communities. The focus should be on cooperation and support, rather than division and blame.

Conclusion

Microbes transcend borders, but stereotypes create divisions. Adopting WHO’s scientific naming conventions is crucial to ensure accuracy, fairness, and global collaboration in disease control.

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