Debate over renaming smallpox from monkeys gains momentum after attacks on primates

August 12, 2022

Robert

The attacks against primates that have been taking place in Brazil, resulting from a mistaken association between the presence of animals and the increase in cases of smallpox in monkeys, have had global repercussions and have given new impetus to requests for the WHO (World Health Organization) to change the disease name.

Asked about the issue in Geneva this week, epidemiologist Margaret Harris, spokeswoman for the entity, condemned violence against animals and reiterated her intention to find a better name for the disease. In mid-June, the director of the WHO, Tedros Adhanom Ghebreyesus, had already publicly announced this wish.

Monkeypox was only named that way by chance: the first time it was identified and described was precisely in a group of primates in a laboratory in Denmark, in 1958. “Actually, the virus is more common in rodents”, recalls the WHO epidemiologist. Scientists still do not have a consensus on which animal would be the natural reservoir of the virus, which has already been documented in different animals, including dogs.

Several entities, from animal protection associations to health organizations, have also publicly spoken out asking for a change in the nomenclature.

“Monkey pox is a bad name because it seems to convey the message that monkeys are responsible for the disease, which is not correct. In fact, they are just as much at risk as we humans and other animals are of catching the disease.” “, says infectious disease specialist Raquel Stucchi, a professor at Unicamp (State University of Campinas).

The doctor points out that there is great dissatisfaction with the nomenclature among Brazilian infectologists and epidemiologists, who have been asking for changes for more than three months, since the identification of the first cases of the current outbreak.

Despite the apparent consensus, the change is not an easy task, nor does it have a set deadline.

There are precedents for changing the names of diseases considered problematic and stigmatizing. The process, however, is bureaucratic and usually slow.

In the specific case of monkeypox, there are two issues: the name of the virus and the nomenclature of the disease, each under the responsibility of a specific entity.

The International Committee on Taxonomy of Viruses (ICTV) has the final word on changing the name of the pathological agent. The organization currently has a project to bring the names of viruses closer to the format in which other organisms are registered.

Changing the name of the virus, in English called “monkeypox”, would need to go through the organ first.

Sources linked to the committee say there is a willingness to make changes, but many point out that a radical change, with the total abandonment of the use of the term “monkeypox”, could compromise the scientific literature that has been produced on this virus for more than 60 years. .

Epidemiologist Raquel Stucchi believes that, with the internet and current documentation tools, changing the name of the virus would not pose a big problem.

“The price of keeping the name monkeypox is much higher than any problem with the scientific literature”, says the doctor, who cites the frequent occurrence of name changes of viruses and bacteria as an example.

As for changing the name of the disease, in theory, the process could be more simplified, as it falls within the umbrella of the World Health Organization.

Since 2015, the WHO has a best practice guide for naming new diseases. According to the document, more generic descriptive terms should be used, without associations with geographical indications, personal names or species of animals or plants. In the current pandemic, the choice of the name Covid-19 has already followed this criterion.

The problem is that there is no guidance on what to do with the names of diseases that already existed before the guidelines. The list of diseases that do not comply with the new rules is quite extensive, as for centuries it was relatively common for new diseases and viruses to end up named after animals or geographical regions.

And that lasted until a very short time. In 2009, the disease caused by the H1N1 virus was first called swine flu. Another example is the Middle East Respiratory Syndrome (MERS) of 2012.

“The work to see the name issue is happening. It’s a big job. We’ll have news soon, but unfortunately, it’s not yet,” said WHO’s Harris last Tuesday (9).