Monkeypox outbreak: what you need to know
While the scientific community is trying to learn more and more about the monkeypox epidemic, federal public health has let the possibility of offering smallpox vaccines in Quebec linger. Here is an analysis by Michael Head, Senior Researcher in Global Health at the University of Southampton.
ANALYSIS – After Europe, Quebec. Quebec public health confirms two cases of monkeypox, and is currently investigating about twenty others. A first case has also been identified in France.
This is the latest twist in an outbreak that originated in Europe, with nine confirmed cases in the UK and around 40 suspected or confirmed cases in Spain and Portugal.
This is only on May 6 did the UK Health Security Agency (UKHSA) confirm the first case in Europe. Three cases were previously reported in 2021 and one in 2018. These reports were mostly related to international travel from West and Central Africa, where the disease is endemic.
This is the highest spread of this disease ever observed in Europe and America, but it is not known if these cases are linked.
A false appellation
The monkeypox — its scientific name — was first observed in the late 1950s in laboratory monkeys, hence its name. But scientists now doubt that monkeys are the primary carriers. According to a recent hypothesis, they are rather related to rodents, in particular the savannah cricetome, also called the Gambian rat.
Unlike Covid, monkeypox is poorly transmitted between humans. It generally requires interaction with carrier animals, very close contact with an infected person or contact with a passive vector (contaminated clothing, towels or furniture). Monkeypox would not spread asymptomatically. However, this virus is still little known, but current epidemics will bring a lot of new information.
Monkeypox belongs to the same family of viruses as smallpox, but it is much less contagious. People who catch it usually have a fever and have a characteristic rash and blisters. The disease is usually “self-limited”: symptoms usually go away on their own within a few weeks. But in its severe form, the mortality rate can vary between 3 and 6%, particularly in children.
A sexually transmitted disease?
According to the UKHSA, some cases of the May 2022 outbreak are not associated with international travel, suggesting community transmission. For four of the seven confirmed British cases, the patients identify as gay, bisexual or having had homosexual relations. On Twitter, a UKHSA epidemiologist would suggest “spread in sexual networks”. The Spanish cases would also point in this direction.
The current spread would therefore be unusual compared to previous outbreaks. Although much is unknown about monkeypox, it is nevertheless known that the virus is transmitted by close contact, such as skin to skin.
There is no evidence that it is a sexually transmitted infection in the manner of HIV or chlamydia, although close contact during sexual or intimate activity may have been a key factor in the spread in the UK.
Even if we had never documented a case of transmission in this intimate or sexual context, this information does not change what we already knew about its transmissibility, which requires close contact. But this insight into the social dynamics that are emerging in the current contagion will certainly be useful to public health teams in their search for others who may have been exposed.
Very low risk for the population
The risks associated with monkeypox for the general public are extremely low, due to its low transmissibility, but also because the means of containing this virus exist.
Even if it does not exist A specific monkeypox vaccine, smallpox vaccine (an antiviral) and gamma globulin antivaccine can be used to control it, according to the US Federal Centers for Public Health (USCDCP).
According to some experts, population immunity to monkeypox may have waned due to the cessation of widespread vaccination against smallpox, making further spread more likely. At a meeting held in London in 2019, experts speculated that the eradication of smallpox may have resulted in “having created a vacant epidemiological niche that could be filled by the emergence of smallpox. monkeypox in humans”.
Certainly, these cases of monkeypox and other diseases (such as Ebola, malaria and Lassa fever) reveal a high infectious burden in parts of the world, where access to health care is limited. In a post-pandemic world, we will certainly have to strive to better understand these serious pathogens, and others, both for their effect on local populations and on the world.
Michael Head, Senior Researcher in Global Health, University of Southampton
This article is republished from The Conversation under a Creative Commons license. Read the original article.