Internationally, both confirmed and suspected cases of monkeypox are increasing. Many of these are of unknown origin, meaning that the virus that causes it is likely spreading under the radar of health authorities.
Scientists are beginning to express concern about the possibility of a new outbreak, as cases have been identified in at least seven countries and that number is growing every day. Here is a summary of what is known so far in the form of a Q&A, based mainly on New Scientist.
It is a relatively rare disease caused by a virus (Poxvirus) that belongs to the same family as the smallpox virus. The disease usually spreads among monkeys in Central and West Africa, where it is endemic, but periodically jumps to humans, having caused small outbreaks to date. It was first identified in laboratory monkeys in 1958. The first case of human infection was recorded in the Republic of Congo in 1970.
How many cases have there been in the current outbreak
There have been 35 confirmed cases worldwide and another 72 suspected cases, according to the database created by Morris Kremer of Oxford University and John Brownstein of Harvard Medical School. Confirmed cases have been found in the UK, Portugal, Spain, Sweden, Belgium, the US and Canada. Scientists believe that this is probably only the tip of the iceberg and that there are many more undiagnosed cases.
It is not clear whether all the cases are linked. There have been cases linked to another known case, and others with no (at least known) link. UKHSA now estimates that the virus is spreading from person to person in countries with confirmed cases. Several involve male homosexuals and bisexuals, so health authorities are urging people of this sexual orientation to watch out for any rashes or other suspicious symptoms so that they can seek medical attention in good time.
How does the disease spread?
According to the World Health Organization (WHO), it can be transmitted by inhaling infected particles and by contact with skin rashes of the disease or materials contaminated with the virus. According to the US Centers for Disease Control and Prevention (CDC), human-to-human transmission is believed to occur mainly through large respiratory particles that do not travel far, so there must be prolonged close face-to-face contact to become infected.
The virus is not thought to spread easily between people and, according to the UKHSA, the risk of infection in the population remains low. The disease can also be spread through contact with an infected person's clothing, towels, sheets or other items. It is not considered a sexually transmitted disease, but it can be more easily transmitted during sexual contact through the skin.
Furthermore, it can be transmitted from an infected animal to a human if one is bitten by it or touches its blood, bodily fluids, rashes, etc,
What are the symptoms?
They include fever, headache, muscle aches, back pains, swollen lymph nodes, chills and exhaustion. Rashes may also appear, first on the face and then on other parts of the body, including the genitals. The rash initially resembles that of chickenpox.
How deadly is it?
The disease is usually mild and most patients recover in a few weeks without treatment. In Africa it can kill up to 10% of people infected, but this is for one of the two strains, that of the Congo, which is more dangerous, according to the WHO, while the other strain, from West Africa, kills one in 100 patients. So far, genetic analysis has identified only the second West African strain in Britain, but there is no equivalent sequencing data from other countries.
The above death rates are the proportion relative to confirmed cases, but given that there are probably several more mild cases that go undetected, the actual mortality of the disease is estimated to be significantly lower. According to the WHO, children are more at risk than adults of becoming seriously ill. Also infection of a pregnant woman can lead to pregnancy complications and even stillbirth.
Treatment
The antiviral drug tecovirimat (Tpoxx) has been approved in the US and Europe against this disease and dammalitis in animals. The drug significantly reduces the likelihood of death. There is also the vaccine Jynneos (also known as Imvanex and Imvamune), also approved in the US and Europe, which prevents infection in adults. In addition, those old enough to have been vaccinated against smallpox as children still have some protection.
Outbreaks in the past
There have been several outbreaks in the past, but usually involving only a few cases each time and with a very limited geographical spread.
The current outbreak is not the largest ever. There have been larger ones in Africa, such as in 2001 and 2002, when 485 cases and 25 deaths were recorded in the Republic of Congo. In 2017 and 2018, 122 confirmed or probable cases and seven deaths were reported in Nigeria.
However, the fact that so many cases are being detected in different countries suggests that this is a more contagious strain than others in the past. Although it is possible that simply random events, such as the presence of super-carriers, may have helped an older strain of the virus spread more widely. It is too early to draw a definitive conclusion. Genetic analysis of more samples from outbreaks will reveal whether it is a different strain.
Is a new pandemic likely to emerge?
The scientists' assessment is that the new outbreak can be controlled by contact tracing and vaccinating those considered at risk of infection. While they do not completely rule out a pandemic, they do not consider it likely and do not think it is on the same level as coronavirus.
Source: CNA
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