Emergence of new infections and new technologies: Challenges and opportunities

In recent years, while diagnostic facilities have improved in all fields of medicine to cover infectious and non-infectious diseases, several newer diseases have emerged, or old diseases have re-emerged in new forms or with more virulence and pathogenicity. We recently faced the brunt of the COVID-19 epidemic, in which millions of people lost their lives. Even though the number of COVID-19 cases came down drastically after mass vaccination and booster vaccination by the end of 2021 this reduction in the number of new cases and severity of the infection led to complacency in the public not taking booster doses of the vaccine, which resulted in reduced herd immunity on one hand and the emergence of new variants on the other hand. These new variants are escaping the residual antibodies^[1] and our immune system, with spikes in the new cases in recent months.^[2]

In addition to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which caused COVID-19, numerous viral diseases keep on emerging and re-emerging. In this issue of the Journal of Laboratory Physicians (JLPs), one article provides updated information on Monkey B virus (BV). Roy et al.^[3] throw light on the history of this virus, which was first discovered in 1932, but remained less known for several decades, primarily because of the zoonotic nature of the infection. But with much awareness and improved diagnostic infrastructure, several cases of Monkey BV started being reported in 2023 and onward, when the number of COVID-19 cases was at its lowest. The World Health Organization in the middle of 2024 also issued an advisory on outbreaks of Monkeypox virus (MPXV), which could result in another outbreak. This created awareness in public and also confusion, not only among the non-medical persons but also the medical fraternity who are not from the virology field. Indeed, Monkey BV and MPXV are interchangeably used by many as both are zoonotic viruses. Both can infect monkeys, but they are not the same. While the monkeypox is an “orthopoxvirus” belonging to the family of “pox viridae,” the Monkey BV is an “alphaherpesvirus” belonging to the “herpes viridae” family. Monkeypox can spread from animals to humans and from human to human, while Monkey BV primarily spreads through contact with infected monkeys, particularly through bites, scratches, or exposure to their saliva. By the end of 2024, at least 30 confirmed cases of Monkey BV were reported from India. However, the number could have been much more, as several cases were laboratory confirmed from various parts of the country but never reported to the national database. Yet another re-emerged viral disease is human metapneumovirus (HMPV). The HMPV is an enveloped and negative-stranded pathogen with a similar tout of transmission and pathogenesis as SARS-CoV-2. Diksha et al. discuss the emergence of this viral disease with confidence that, with better preparedness to handle such epidemics, the country and the world will be able to control this infection.^[4] The authors assure that there is no reason to be scared.

However, the sudden emergence of artificial intelligence (AI) tools making inroads into all fields of our lives, including medicine, has both reasons to feel happy but also to worry. Even though the name AI was first used almost 70 years ago, it was primarily used for mathematical analyses. However, the era of information technology and computational sciences, with machine learning (ML), deep learning (DL and smart phonology, the AI has suddenly erupted when the world was not yet ready for such transformation. AI has suddenly exploded when the world was not yet ready for such transformation. The AI has innumerable advantages and is making our lives much easier and tempting, including patient management and diagnostic medicine.^[5] However, its impact on medical education, ethics in research, publication, and misuse of personal data, creation and morphing of the images, and even data generation based on simply one’s imagination has wide repercussions.^[6] It has concerns, and several governments have started issuing guidelines covering challenges the common person can face. Such guidelines have been discussed and issued by several bodies, including the European Parliament in the form of “The Ethics of AI: Issues and initiatives.”^[7] The AI has the potential to manipulate the data, use personal information, develop biased algorithms, and devaluation of human judgment, besides scientific and manuscript writing.^[8] To combat the use of AI in manuscript writing, almost all reputable publication houses have issued guidelines on the use of AI.

Whether it is an AI-based information or manually developed protocols for the processes and products, quality remains of paramount importance. This issue of JLP also includes one article on quality control in hematology^[9] and quality control in antibiotic drug susceptibility testing.^[10] Despite some concerns for the last few months due to the change of the publisher, I hope that after the resolution of all these disputes, the JLP will not only regain its reputation but will assume newer heights in the coming times.