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Monkeypox: Is it possible to become a pandemic?Here is everything you need to know

Monkeypox virus particles captured via colored transmission electron micrographs

UK HEALTH SECURITY AGENCY / SCIENCE PHOTO LIBRARY

Concerns about the development of monkeypox are growing, with dozens of confirmed cases appearing daily.

Here’s what we know so far:

What is monkeypox?

Monkeypox is a virus-induced disease that, as the name implies, usually spreads to monkeys in Central and West Africa, but sometimes jumps to humans and causes small outbreaks.

It was first discovered in laboratory monkeys in 1958. The first human case was confirmed in 1970 in the present Democratic Republic of the Congo.

How many cases are there in the current outbreak?

At the time of publication, 109 cases of monkeypox were confirmed or suspected worldwide. List of reports Compiled by Moritz Kramer John Brownstein and his colleagues at Children’s Hospital, Oxford University.

In the United Kingdom, there are nine confirmed cases, primarily in London. Portugal has 14 confirmed cases and 20 suspicious cases, and Spain has 7 confirmed cases and 24 suspicious cases. There are two suspicious cases in Italy and two suspicious cases and one confirmed case in Belgium. France and Sweden each have one confirmed case.

In the United States, there is one confirmed case and one suspicious case. There are 1 confirmed case and 21 suspicious cases in Canada. There is one confirmed case and one suspicious case in Australia.

Kraemer and Brownstein believe that these cases may be the tip of the iceberg. “It’s probably more extensive than we’re currently detecting,” says Kraemer.

Are the cases linked?

It’s not clear yet, says Kraemer and Brownstein.

The first person confirmed to be infected in the United Kingdom traveled to Nigeria. They developed a rash on May 5th and were hospitalized on May 6th, but recovered completely. Two of the other UK cases are related to this first case, The latest four cases in the UK do not have a known link to the previous caseAccording to the UK Health Security Agency (UKHSA).

In the latest update of the organization, UKHSA’s Susan Hopkins said the monkeypox virus is now spreading from person to person in countries with known cases. “These latest cases, along with reports of cases in countries across Europe, support our first concern that monkeypox could spread within our community,” she said. rice field.

According to UKHSA, recent cases in the UK are primarily gay men, bisexual men, and men who have sex with men. “We especially encourage gay and bisexual men to notice abnormal rashes and lesions and contact sexual health services without delay if they have any concerns,” Hopkins said.

How does it spread?

According to the World Health Organization (WHO), “Monkeypox can be transmitted by droplet exposure through large exhaled droplets and contact with infected skin lesions or contaminants.” Some might interpret this as meaning that the virus is levitating, but WHO does not use this term.

The Centers for Disease Control and Prevention (CDC) said:: “Human-to-human transmission is thought to occur primarily through large respiratory droplets. Respiratory droplets generally cannot travel more than a few feet and require prolonged face-to-face contact. is.”

However, the virus usually does not spread easily among people, and UKHSA states that the risk to the UK population remains “low” in the ongoing outbreak.

Monkeypox can also spread through close contact or contact with clothing, towels, and bedding used by infected individuals.

Although not considered a sexually transmitted disease, UKHSA states that it can be transmitted through skin-to-skin contact during sexual intercourse.

Monkeypox can also be caught from Wildlife infected in parts of West Africa and Central Africa.. This can occur if you are bitten or touched by animal blood, fluids, stains, blisters, or scabs. Monkeypox can also be transmitted by eating undercooked meat in infected animals.

What are the symptoms?

The first symptoms of monkeypox include fever, headache, muscle aches, back pain, swollen lymph nodes, chills, and malaise, UKHSA says.

The rash can usually occur first on the face and then on other parts of the body, including the genitals. Before forming a scab, the rash may initially look like chickenpox.

How deadly is it?

Monkeypox is usually mild and most people recover within a few weeks without treatment.

According to the CDC, monkeypox can be fatal in 1 in 10 people with illness in Africa. However, there are two main types of monkeypox, Congolese strains and West African strains. WHO states that one-tenth of the numbers apply to Congolese strains and West Africa strains are fatal in about 1 in 100 reported cases.

Of the ongoing outbreaks, only West African strains were identified in the United Kingdom. Virus sequencing information is not yet available elsewhere in the world.

In addition, according to WHO, these numbers indicate the mortality rate of people with confirmed infections, called case fatality rate. However, in mild illnesses, it often remains undetected. In other words, the mortality rate from infection (the mortality rate of all infected people) can be significantly lower.

According to WHOChildren with monkeypox are more likely to be more seriously ill than adults.

Infection during pregnancy can also cause complications such as stillbirth.

Is there a cure or vaccine?

Yes. The Antiviral drug Tecovirimat (Also sold under the brand name Tpoxx) is approved in Europe for the treatment of monkeypox, smallpox and cowpox. Only approved for smallpox in the United States. In animal studies, tecovirimat significantly increased the survival rate of animals fed very high doses of monkeypox.

There is also a vaccine called Jynneos (also known as Imvanex and Imvamune). It is approved in the United States and Europe to prevent monkeypox and smallpox in people over the age of 18.

In addition, people of sufficient age to be vaccinated against smallpox as babies need some protection. Routine vaccination against smallpox ended in the United Kingdom in 1971 and in the United States in 1972.

Has it happened outside of Africa?

Although there have been several monkeypox outbreaks outside Africa, they usually include only a handful of cases with very limited local spread. For example, in 2021, the UK reported three cases in a household, one of whom traveled to Nigeria. In 2018, a person arriving from Nigeria spread the virus to two people in the United Kingdom, including one healthcare worker.

Does that mean that the current outbreak is the largest ever?

No, there was a major outbreak in Africa. For example, in 2001 and 2002, 485 cases and 25 deaths were reported in the Democratic Republic of the Congo, where the virus is present in monkeys.

In 2017 and 2018, 122 confirmed or possible cases reported in Nigeria, 7 people died. In many cases it is probably not reported.

Can this outbreak be caused by a new strain of monkeypox?

It remains unknown. The fact that so many cases have been reported in some countries certainly suggests that this strain is more contagious than other strains. However, accidental events can help the virus spread more widely, such as being carried by a “super spreader”.

“It’s too early to gain insight into what’s happening,” says Brownstein.

Health authorities have sequenced a sample of the virus, which reveals whether it is significantly different from the previously identified variants of the West African strain and whether all known cases are associated. ..

Could this be another pandemic?

As with all previous monkeypox outbreaks, it is expected that this outbreak can be contained by contact tracing. The United Kingdom provides vaccines to contacts who are considered at high risk of infection to prevent the virus from continuing to spread.

Researchers haven’t completely ruled out the pandemic, but they don’t think it’s possible at all. “At this point, I don’t think science points to that,” says Brownstein. “It is important not to bring this to the same level as the new coronavirus.”

Some researchers have previously warned that monkeypox is becoming an increasing threat. “The emergence of monkeypox as an important human pathogen is arguably a realistic scenario.” I am writing a paper for 2018..

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Articles modified to May 20, 2022

This article has been modified to correct Brownstein’s affiliation and Tpoxx’s geographical approval.

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Monkeypox: Is it possible to become a pandemic?Here is everything you need to know

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