UKHSA publishes health-security risk assessment ranking pandemic threats

UKHSA has published a new Health Security Risk Assessment that ranks 21 health threats the agency says could trigger a pandemic in the UK over the next five years.

The assessment puts respiratory infections at the top of the list, with influenza and a novel coronavirus identified as the two highest-risk pandemic scenarios. UKHSA says the exercise is designed to help planners and health services prepare for outbreaks that could place pressure on hospitals, vaccination programmes and surveillance systems.

The report is a planning tool rather than a forecast. UKHSA says the timing and scale of future outbreaks are difficult to predict, but that decision-makers need to focus on the scenarios most likely to cause major disruption if they emerge.

Five-year risk ranking

The assessment ranks threats by likelihood and impact over a five-year horizon. Alongside flu and a new coronavirus, it includes measles, tuberculosis, mpox, invasive candidiasis, Ebola, lassa fever, Nipah virus, dengue, Zika, tick-borne encephalitis, STEC, typhoid, salmonella, drug-resistant gonorrhoea and hepatitis B.

UKHSA also groups risks into broader categories including contact-transmitted, vector-borne, foodborne, sexually transmitted and blood-borne infections. That wider framing shows the agency is treating pandemic preparedness as more than a single-virus problem.

The ranking is meant to inform preparation across several parts of the health system. A respiratory outbreak can move quickly through communities, but other threats can challenge different parts of surveillance, diagnostics, vaccination and treatment planning.

Why flu and coronavirus lead the list

Respiratory infections sit at the top of the assessment because they can spread rapidly and change over time. UKHSA’s report identifies flu and a novel coronavirus as the two leading pandemic scenarios within that category.

The agency’s reasoning is that these kinds of viruses can mutate, which can reduce the effectiveness of vaccines and other interventions. That makes them especially important for preparedness planning, even when there is no active emergency.

The report sets out reasonable worst-case scenarios for those threats. In one influenza scenario, a new strain could infect more than half the UK population across multiple waves over two years.

In the novel coronavirus scenario, the report says a new virus could infect 10 million people in the UK and cause 100,000 deaths in the first year.

Those figures are not predictions. They are high-end planning assumptions intended to stress-test readiness, hospital capacity and outbreak response systems before a real emergency develops.

The broader threat list

The report’s wider list shows the variety of infections UKHSA wants planners to keep in view. Measles and tuberculosis remain part of the picture because they can drive serious outbreaks when coverage or detection is weak.

The list also includes mpox, invasive candidiasis, Ebola, lassa fever and Nipah virus, all of which carry different risks depending on how they spread, where they emerge and how quickly they are detected.

Vector-borne diseases such as dengue, Zika and tick-borne encephalitis are also included, along with foodborne threats such as STEC, typhoid and salmonella. The assessment also names drug-resistant gonorrhoea and hepatitis B.

That mix matters because it shows the public-health challenge is not limited to one transmission route. The report is aimed at ensuring preparedness across respiratory, contact-transmitted, vector-borne, foodborne, sexually transmitted and blood-borne threats.

UKHSA’s warning

Steven Riley, UKHSA’s chief data officer, said the UK faces diverse and complex health-security threats and that their timing and magnitude are difficult to predict.

That framing is central to the report. UKHSA is not saying the next pandemic will come from one specific pathogen. It is saying public-health systems need to be ready for a range of plausible scenarios that could unfold in different ways.

The report also points to recent threats that have already tested the system, including mpox clade Ib, botulism, meningococcal B and hantavirus outbreaks. Those examples show the agency’s risk picture is shaped by both familiar infections and less common incidents.

The inclusion of antimicrobial-resistance concerns, including drug-resistant gonorrhoea, broadens the preparedness lens further. It reflects the possibility that infections can become harder to treat even when they are not new in themselves.

Why it matters

The publication matters because it gives a formal ranking to the threats UK health planners are expected to weigh over the next five years.

For hospitals, the question is capacity: how to handle a surge if a respiratory virus spreads widely, or if another threat creates pressure on diagnostic, treatment and isolation systems.

For vaccination programmes, the report reinforces the need to keep coverage high for preventable diseases such as measles while also leaving room for new or updated vaccines if a novel pathogen emerges.

For surveillance systems, the assessment is a reminder that preparedness has to work across multiple routes of spread at once. Respiratory viruses, vector-borne diseases, foodborne infections and sexually transmitted threats all require different monitoring and response tools.

The practical value of the report is that it pushes those questions into the open before an outbreak begins. It is not asking planners to bet on one scenario. It is asking them to stay ready across several.

What happens next

The immediate next question is whether UKHSA publishes a fuller summary or the report itself on its own channels.

Another open question is whether other major outlets independently confirm the report’s figures and whether ministers or public-health officials attach any concrete policy action to the assessment.

For now, the key development is the publication itself: a fresh official risk ranking that puts pandemic preparedness back into focus and identifies flu, novel coronaviruses and a long list of other infectious threats as priorities for the next five years.