Why is ‘monkey pox’ unlikely to become a pandemic? This and 3 other questions about the disease

The outbreaks of the so-called monkeypox in more than a dozen countries have raised several questions in the scientific community and in the population that still remain without clear answers.

The virus usually circulates only in the West and Central African regions, but what is observed now, with transmission on several continents, is surprising and worrying.

In the past, the small number of cases that emerged in other parts of the world were related to people traveling to affected countries and bringing the virus home. But it is now unclear how people are getting infected.

Although patients are doing well, the scientific community is working to better understand what is happening.

Check out some of the main unknowns about monkeypox below.

1. Can monkeypox become a pandemic?

“It’s quite unlikely,” Professor Brian Ferguson, from the Department of Pathology at the University of Cambridge, UK, tells BBC News Mundo (the BBC’s Spanish service).

There seems to be a consensus in the scientific community that we are far from monkeypox becoming a pandemic.

And why is monkeypox considered unlikely to become a pandemic?

The first reason is that it is very difficult to transmit from person to person, unlike a respiratory virus like Sars-Cov-2.

The transmission of monkeypox occurs when a person comes into contact with the virus through an animal, human, or contaminated materials.

It is not known which animal is the reservoir host (main carrier of the disease) of monkeypox, although African rodents are suspected to be involved in transmission, according to US Centers for Disease Control and Prevention guidelines.

To become infected from another human being, there must be close contact, with temporary fluid exchange and direct or indirect friction with infected material.

The second reason is that the obvious symptoms of monkeypox, especially the appearance of pustules on the skin, help to identify cases more quickly and control outbreaks relatively easily.

And finally, it is a disease that, although many have not heard of it until now, has been known since 1958 and is extensively studied.

But scientists say that one should not relax in the fight against smallpox in monkeys. This is the biggest outbreak of the virus ever seen outside of Africa.

2. Why are we seeing simultaneous outbreaks in multiple countries?

Answering that question is the main urgency for scientists — the key to preventing new cases from appearing.

At the moment, smallpox appears to be spread primarily through sexual activity, which does not imply that it is a sexually transmitted disease.

“But the unusual occurrence of multiple outbreaks in multiple countries means we need to be open-minded about what happened and not rule anything out right away,” says Ferguson.

Therefore, other possibilities of transmission are currently being investigated, such as through aerosols, “if there has been any change in the way the virus is transmitted”, says the specialist from the University of Cambridge.

It is too early to draw conclusions, but at the moment there is no evidence that we are dealing with an unknown variant of the pathogen.

Early genetic analyzes suggest that current cases are strongly related to the forms of the virus seen in 2018 and 2019.

One possibility is that the virus was simply in the right place at the right time to spread, as we’ve seen over the past decade with the Ebola and Zika viruses, which without changes in their genetics led to unexpected outbreaks.

Medical researcher Jeremy James Farrar, director of the Wellcome Trust (a London-based biomedical research charity) spoke to the BBC about the possibility of a “super-spreading event” where people were infected and carried the virus to different countries.

3. Why are we seeing more cases in gay men?

Do sexual behaviors facilitate spread? Is it just a coincidence? Is the community more attentive to sexual health and to performing medical tests that facilitate diagnosis?

What has been observed is that many of those affected are young homosexuals and bisexuals, but scientists warn that “there is nothing biological about the virus that says this community is more susceptible than others,” says Ferguson. He says it is important not to stigmatize this group.

“We are all equally susceptible to monkeypox, as far as we know. It’s not dependent on sexual preference and it’s not a sexually transmitted disease either.”

The reason these outbreaks seem to hit this demographic the hardest may be more a matter of luck than a specific feature in the biology of the virus.

Experts consulted by BBC News Mundo, the BBC’s Spanish service, say that children would be more susceptible to the virus because they have a less developed immune system.

And because the human smallpox vaccine, eradicated in 1980, appears to work against monkeypox, people over 55 years of age and given the immunizer may be more protected than younger adults who haven’t been vaccinated.

4. Will there be many more cases in the coming weeks?

It’s a little difficult to predict because the magnitude of the infections and the reasons why we’re seeing the biggest outbreak of this disease outside of Africa are still not fully understood.

However, experts insist that once cases are identified and health alerts issued, it should be “relatively easy to control outbreaks”.

“Now that it is known that the virus is circulating and that this information has been given to society, the logical thing is to wait for more specific cases to appear, but that in the course of four or five weeks the cases will disappear”, Raúl Rivas González told the BBC, professor of microbiology at the University of Salamanca, Spain.

Scientists point out that what we are seeing is yet another example of the danger that humanity faces with emerging viruses, especially those of animal origin.

“Contact with wild animals is increasing due to deforestation, uncontrolled urbanization, tourism and climate change. There are a number of factors that, along with low herd immunity, make outbreaks appear more frequently, which is what is happening.” happening,” says Rivas González.