Emerging infectious diseases are typically characterized as previously unknown disease outbreaks; known diseases that have quickly increased in frequency or territory-spread over the last 20 years; or contagious diseases that are uncontrollable.1 Examples of worldwide emerging diseases include human immunodeficiency virus (HIV) infection, severe acute respiratory syndrome (SARS), Lyme disease, West Nile and Zika virus diseases, dengue fever, hantavirus infection, and Escherichia coli O157:H7 infection.1 The Centers for Disease Control and Prevention (CDC) notes that some emerging diseases may be regionally experienced as new or previously unknown infections or reappearing contagious diseases that have evolved to become drug-resistant.2 Vaccination prevents many deadly infectious diseases but for those associated with lethality and without immunization options, scientists report worries that these diseases could become pandemics similar to COVID-19. Examples of some potential future pandemics include Ebola, Marburg virus disease, Lassa fever, Middle East respiratory syndrome coronavirus (MERS-CoV), SARS, Nipah, Zika, Crimean-Congo hemorrhagic fever, Rift Valley fever, and monkeypox.3

Nurses have a professional obligation to be aware of these infectious disease threats and to conduct risk assessments vigilantly and regularly during patient care encounters. Should providers identify potential concerns, they are expected to respond with actions consistent with public health requirements, including reporting expectations. Since December 2019 when the World Health Organization China Country Office was informed of multiple cases of pneumonia of unknown etiology detected in Wuhan, Hubei Province,4 health professionals have witnessed the spread and dangers of COVID-19 and participated in battling to reduce its associated mortality, morbidity, and human suffering costs.

Other infectious diseases will undoubtedly lead to future pandemic events, likely associated with death and wellness compromise. Continued and recent public health experiences related to COVID-19 and its persistent variants should be described, tracked, and evaluated to inform response plans for future pandemics. Holistic nursing care provision requires purposeful planning so that upcoming pandemic responses are improved using lessons learned following the devastating assaults of COVID-19 on public health.

It is unrealistic to expect nurses to individually recognize the unique signs and symptoms of each known and future emerging disease risk, regardless of the accessibility of technologies designed to assist with diagnostic decision-making. There are lessons from COVID-19 experiences and from recent monkeypox spread that may provide a broad framework from which nurses might recognize potential infectious diseases and appropriately investigate, refer, or report.

Public health leaders have offered analysis as to lessons learned via the COVID-19 pandemic.5 Experts concur that the pandemic has illuminated the fracture lines and divides that exist within society related to social and structural determinants of health. Adverse health and the economic effects of racism observed and lived during the pandemic revealed staggering and disproportionate rates of infection and mortality based on race, economics, and social demographics. Disparities were also revealed on the basis of education and technology access and evidenced by whether people could pivot to technologies to support remote work. Many essential workers shouldered the difficult, often physically laborious, and mentally taxing responsibilities of providing critical support services to public and private enterprises at significant personal and familial risk of illness. These disparities must be aggressively considered and corrected so that emerging diseases do not foment the same inequitable chaos and adverse outcomes.

Public funding to support public health preparedness was revealed during the pandemic as insufficient for a robust, responsive, and comprehensive public health system. This lesson has implications for nurses as policy leaders and influencers, and voters. The pandemic also revealed that political divisiveness and a lack of coherent leadership contribute to poor public health outcomes, regardless of the wealth or size of the country.5 False information and poorly informed but persuasive health workers, at times including nurses, contributed to messaging that damaged public trust and thwarted use of science-based immunization opportunities. Nurses must consider how they should educate themselves and others by using rigorously appraised or highly regarded sources of information. Appropriate role modeling is also valuable, particularly as related to vaccination.

Nurses may additionally benefit from considering lessons that have implications for direct patient care delivery, including strategies appropriate for individual patient assessment. Consistently incorporating questions about travel during patient assessments needs to become a standard of care to facilitate early detection of potential infectious diseases. It makes sense that this question might be curtailed or avoided when working with clients for whom travel is not realistic; however, asking about family members' or friends' travel may be a reasonable query.

Emerging infectious diseases require nurses to talk more openly and frequently about sexual activity during routine patient encounters.5 Immunization histories should be regularly updated, and vaccination counseling should be routinely provided. Nurses and other health providers should commit to providing current, up-to-date, and nonpoliticized information regarding emerging diseases and be careful to avoid stigmatization. Monkeypox is one example of a current emerging infectious disease that has been associated with stigma because of its high rate of spread within the population of men who have sex with men.6 Although anyone can become infected with human monkeypox (MPX), recognizing patterns is important in public health and sexual encounters do influence MPX transmission, potentially because of skin-to-skin contact. Nurses are challenged to share research-supported epidemiological facts while making clear that MPX, or other infectious diseases, are not about who people are but rather about people's behaviors.6 As nurses continue to contribute to the public and individual needs of those at risk of experiencing infectious diseases, they have an opportunity to incrementally build a holistic repertoire of evidence-based interventions that are informed by previous experiences and refined through research, including those learned during the COVID-19 pandemic or recognized during the current global outbreak of monkeypox.

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