Figure 2. The severity of emerging infectious diseases is influenced by the host–pathogen interaction.
Many zoonotic agents cause little or no signs of disease in their natural hosts, such as wild birds and bats, but transmission hosts might present with disease symptoms ranging from moderate (for example, pigs infected with avian influenza virus) to severe (for example, horses infected with Hendra virus). The terminal or spillover host can present with severe symptoms and high mortality rates (for example, in the case of humans infected with H5N1 influenza and Hendra virus). For some of the most recently identified emerging infectious diseases, such as H7N9 influenza and Middle East respiratory syndrome (MERS) coronavirus, natural and transmission hosts have not been conclusively identified (indicated by a question mark). SARS, severe acute respiratory syndrome.