Opinion – Esper Kallás: Monkeypox and the threat of a new pandemic

It happened to a 26-year-old Brazilian who arrived in Bavaria, Germany, after traveling through Portugal and Spain. The presence of vesicles on the skin raised the suspicion that it was a case of monkeypox. German authorities confirmed it was the first case of the disease in that country. With this, there are already 15 countries that register at least one case, until the conclusion of this text.

Still living in the aftermath of the Covid-19 pandemic, a new communicable disease threat emerges, which has been drawing the attention of the international media. In English: “monkeypox”.

Although it got its name when it was identified in monkeys imported to Denmark from Africa in 1958, the disease-causing virus commonly lives in wild rodents and is occasionally transmitted to monkeys and humans by direct skin contact with blisters or scabs. Transmission can also occur through the respiratory system or direct contact.

The disease frightens by the presentation. Skin lesions, with purulent vesicles spread over the body, which can last for weeks and leave scars. Inflammation of lymph nodes, headache and muscle pain, fever and chills may be part of the picture. Some may have organ involvement and death, fortunately uncommon, can occur, especially if affected children under 5 years of age, pregnant women and people with defects in the defense system.

It is only possible to confirm that a person has the virus with tests that detect its genetic material, particularly in the vesicles that appear on the skin. There are blood tests, but they are, for now, inaccurate.

At least for monkeypox, you don’t start with an absolutely unexpected situation, as was the case with Covid-19. The virus has been known for decades, as the first human case was recognized in 1970. It is already known that the smallpox vaccine, which was discontinued in the late 1970s with eradication, provides good protection, approximately 85%, in addition to making the disease milder, if it occurs in vaccinated persons.

There are also drugs that fight the virus. Two antivirals —cidofovir and tecovirimat— already have approval for use, although their access is very limited. Again, international cooperation will be needed to make medications available to areas where cases are occurring.

This is just one more on the list of so-called “neglected diseases”. There are more than a thousand cases reported every year, concentrated in East-Central African countries, where it is considered endemic. Few gave importance to it, as it is restricted to very poor places, far from the major economic and tourist centers.

It was only after the occurrence of one hundred confirmed cases, in addition to one hundred other suspects, in Europe and the United States, that the disease aroused worldwide concern. However, this is a disease with known pandemic potential for a long time.

The question arises: is Brazil prepared to face what could become a new pandemic?

Although monkeypox may be limited to isolated outbreaks, rapid mobilization and perennial strengthening of the care structure, especially the SUS, needs to be improved.

Covid-19, in addition to suffering, brought many lessons. What happened in Brazil should serve as a basis for building solid responses to the new threats that are coming and will come.

No country is shielded or isolated from the rest of the world. Once again, an infectious disease warns that while everyone is not protected, society will still be vulnerable.