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A loud bell has rung again on our island after the first cases of monkeypox were recorded. Familiar words came back to the fore once again after the COVID-19 pandemic: molecular testing, self-containment protocols and close contact tracing. Last month, the World Health Organization (WHO) declared a global public health emergency due to the explosion of monkeypox cases. The state of emergency may not force states to impose protective measures, but it does sound the alarm, highlighting the urgent need to strengthen the collective effort to prevent a potential increase in outbreaks.
The monkeypox virus is not a new virus. Its history goes back about half a century when it was observed in laboratory monkeys in Denmark, hence its name. The first human case was detected in the Democratic Republic of the Congo in the 1970s. Currently, more than 28,000 cases have been recorded worldwide in almost 80 countries, some of which have announced fatalities. Europe accounts for 80% of confirmed cases, making it the epicentre of the spread.
The increase in cases seen in recent months is mainly due to the "behaviour" of the virus, which seems to have become more aggressive. Whereas from 1970 until recently, the most frequent recording of cases was in West and Central Africa, with the exception of the 2003 outbreak in the United States of America, now for the first time there is simultaneous recording of several cases in different countries. Furthermore, it appears that the virus has discovered new routes of transmission, of which what is known is scarce. The monkeypox virus is zoonotic, i.e. it is transmitted from animals to humans through close contact. Human-to-human transmission used to be relatively rare, but today it is increasingly common, either through direct contact e.g. face-to-face, or through indirect contact such as touching infected objects, a fact that further alarms the WHO.
The symptoms of the disease are also a "conundrum". In previous cases, symptoms occurred 5 to 21 days after contact with the virus and included fever, headache, myalgia, chills and lymph node swelling. Then, usually 1-3 days after the fever, the characteristic rash appeared, indicating the peak of the patients' infectivity.
In the current outbreak a different spectrum of symptoms is unfolding. Some patients, in addition to the common symptoms, may experience sore throat or swollen tonsils, with the characteristic rash appearing indefinitely, while they may experience only the rash without any other symptoms. As yet, there are no data on whether a person can be completely asymptomatic. Notably, the severity of the disease is increased in young children, pregnant women and immunocompromised individuals.
Thanks to the shared characteristics of the monkeypox virus with the human smallpox virus, patients with monkeypox who are hospitalized in severe condition can be given approved smallpox medications to optimize their symptoms. In Cyprus, an approved vaccine for monkeypox is already available and persons who are close contacts of a confirmed case or healthcare professionals who have been in contact with a confirmed case may be vaccinated. The vaccine contains an attenuated virus which is closely related to smallpox and simian pox virus. The European Union has approved the vaccine in 2013 against smallpox virus and recently expanded its use to include monkeypox.
It is time to prove that the lessons of the COVID-19 pandemic have been learned and to face the challenges of monkeypox first at an individual level and then collectively. As conscientious citizens, we must protect ourselves and those around us by adhering to health protocols and existing guidelines. The WHO has drawn everyone's attention to prevent the worst from happening. Let us not choose to be "spectators in the same play."
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Prof. Philip Patsalis
Founder and CEO NIPD Genetics a Medicover Company
Contents of this article including associated images are belongs Cyprus Times
Views & opinions expressed are those of the author and/or Cyprus Times
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