Monkey Smallpox: Why Outbreak in Europe and the US Not So Much Concern So Far

In a world that has not yet emerged from a pandemic, another virus has set off alarms in several countries.

Monkeypox, an uncommon disease that has affected people on the African continent for decades, has begun to be identified in countries in Europe and North America.

Although the current outbreaks of the disease have been contained, the emergence of more and more cases in different locations has raised concern.

However, although health authorities point out that there is still not much information about the new outbreaks and their possible transmission routes, they guarantee that there is currently no reason to panic and there are no major risks for society.

“It is important to emphasize that smallpox does not spread easily among people and the risk to people in general is quite low,” said Nick Phin, deputy director of the National Infection Service at the UK Department of Public Health.

Michael Head, a global health researcher at the University of Southampton, says that despite gaps about what is known about the current outbreak, he doesn’t think people need to fear levels of infection like the coronavirus pandemic.

“It would be very rare to see more than a few cases in each outbreak. And we definitely won’t see Covid-19-style levels of transmission,” he told the Science Media Center.

The main difference here is: when the first cases of coronavirus emerged, nothing was known about the disease, but monkeypox is an already known disease, for which vaccines, treatments and information about previous outbreaks exist.

It is also necessary to bear in mind that the monitoring and epidemiological surveillance mechanisms are currently more modern, which makes it easier to detect and identify viruses, new variants and infectious diseases.

Health authorities warn, however, that all this does not mean that one should not watch and act to contain the spread of current cases of monkeypox: viruses mutate frequently and there is no guarantee that one outbreak will be the same as another.

See below in more detail why health experts say the cases reported so far do not pose a serious threat to the general population.

Data indicate that it kills at most 1 in 10 infected people. Mortality is highest among children and young adults, and immunocompromised individuals are particularly at risk of developing the most severe form of the disease.

Symptoms of monkeypox often include fever, headaches, muscle aches, backaches, chills, exhaustion, swollen lymph nodes and skin lesions, which can number in the thousands.

1. It is a known virus

When the first cases of Covid-19 began to be recorded around the world, one of the great doubts was what type of pathogen caused it and what was its origin.

Although Sars-Cov-2 was identified in a short time and several theories suggest that it passed from animals to humans, there is still no precise information about which animal this was and how the virus jumped to people.

But the virus that causes monkeypox has been known for more than half a century, and as a result, we know how it works and how it is transmitted.

Although the virus is believed to have affected people in Africa much longer, it was identified in 1958 in monkeys kept in a laboratory for research. And hence your name.

But later studies showed that the main vectors of the disease are rodents and not monkeys.

“Smallpox was discovered in monkeys in the 1950s, but by the 1970s it had already spread to humans. It is also found in other wild animals, such as some rodents. So monkeys may not be the main natural reservoir of the virus. humans is thought to be due to ingestion of infected animals,” Simon Clarke, professor of cell microbiology at the University of Reading, told the Science Media Center.

Researchers have identified two variants of the virus, one from Central Africa, which causes a disease with more symptoms, and another from West Africa, which causes a milder illness and has been detected in the cases reported so far.

Although in the cases of the new outbreak, medical authorities have pointed out that some patients have in common being men who have sex with men, there is currently no evidence that the virus has mutated into a form of sexual transmission.

2. Are there vaccines and treatments available?

Because it is a known virus that has affected communities for decades, it was possible to develop vaccines and treatments.

As the monkeypox virus is closely related to what causes smallpox, the vaccine developed against smallpox has been shown to be effective for both diseases.

The US Centers for Disease Control and Prevention (CDC) explains on its website that while there are currently no specific treatments available for smallpox infection, outbreaks can be controlled with medication.

There are drugs available on the market that have been approved and shown to be effective against the disease, such as cidofovir, ST-246 and vaccinia immunoglobulin.

There is also a multi-nation approved vaccine for the prevention and treatment of monkeypox called JYNNEOSTM (also known as Imvamune or Imvanex) and is produced by the Danish pharmaceutical company Bavarian Nordic.

Official data show that the vaccine is at least 85% effective in preventing monkeypox.

There is a second smallpox vaccine, ACAM2000, made by Emergent Product Development, which may also offer some protection against smallpox — it was used in a reported 2003 outbreak in the US.

The World Health Organization states that some people who have received smallpox vaccines may also have certain levels of immunity, although in many countries this vaccination was suspended nearly 40 years ago, when the disease was considered eradicated.

Currently, vaccines, in most countries, are only authorized for people over 18 years of age who are considered to be at high risk of contracting the disease.

The UK Health Safety Agency explains that smallpox vaccination can be used before and after exposure.

According to the Bavarian Nordic pharmaceutical company, the US government asked the pharmaceutical company to manufacture millions of doses after the detection of the first case in the country.

3. Not very contagious

The UK Health Safety Agency says that, unlike other communicable diseases, monkeypox does not spread easily between people.

In previous outbreaks, an infected person transmitted the virus, on average, to no more than one person, so contagion levels were very low.

“In most cases, a sick person does not transmit the virus to anyone else,” Jay Hooper of the US Army Medical Research Institute for Infectious Diseases told NPR in a report on the disease.

Head, from the University of Southampton, explains that this is because the virus, in order to be transmitted, needs very close contact, sometimes skin-to-skin, with an infected individual.

According to the World Health Organization, the mortality rate from apepox has ranged from 0 to 11% in the general population and has been highest among young children.

The spread of smallpox can occur when a person comes into close contact with an animal, human, or material contaminated with the virus, which enters the body through broken skin (even if not visible), respiratory tract, or mucous membranes (eyes, nose or mouth).

The UK Health Safety Agency explains that person-to-person spread “is rare” but can occur through:

– contact with clothing worn by an infected person (including bedding or towels)

– direct contact with lesions or crusts on the patient’s skin

– coughing or sneezing from an infected person

4. Monkeypox has caused several outbreaks before

The first human case of monkeypox was recorded in 1970 in the Democratic Republic of Congo, and outbreaks or cases of the infection were reported in several Central and West African countries over the following decades.

Although human cases of smallpox outside Africa are rare, in recent years they have been reported in the United States, United Kingdom, Israel and Singapore.

In fact, in the UK, where the first case of the current outbreak was detected, patients with the disease were also recorded in 2018, 2019 and 2021.

All these outbreaks that were previously detected outside of Africa were very small, with few people infected.

In an outbreak in the US in 2003, for example, 47 people became sick.

The existence of previous outbreaks gives health authorities not only knowledge about the ways in which the virus is transmitted, but also experience in how to contain it, how to treat patients and how to propose ways to reduce the contagion.

However, health agencies in several countries have announced that they will closely monitor the evolution of new cases, since until there is enough data, it cannot be categorically stated that it will be the same now.

In fact, never before have so many cases of monkeypox been reported simultaneously in several countries and without establishing a potential link between infected people traveling to Africa, as is the case now.

What are the symptoms?

Monkeypox is a relative of smallpox, a disease that was eradicated in the 1980s but is less communicable, causes milder symptoms and is less deadly.

It usually lasts two to four weeks and symptoms can appear five to 21 days after infection.

Monkeypox symptoms usually start with a mixture of fever, headaches, muscle aches, backaches, chills, exhaustion, and swollen lymph nodes.

This last symptom is usually what helps doctors distinguish monkey pox from chickenpox or smallpox, according to the WHO.

Once the fever has passed, a rash may develop, which tends to develop one to three days later, usually starting on the face and then spreading to other parts of the body, including the genitals.

The number of injuries can range from a few to thousands.

The rash changes and goes through different stages, and may look like chickenpox or syphilis, before finally forming a crust, which then falls off.