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DAKAR, Senegal – In a part of Nigeria that has been dealing with smallpox outbreaks for years, a doctor saw photos circulating in the Western media this week and laughed.
“It simply came to our notice then a lot serious cases, “said Oyewale Tomori, a virologist in the southwest of the country.” Like, “Ahh! That’s smallpox!”
The virus, discovered five decades ago in the Democratic Republic of the Congo, causes mild illness in most people, he said, along with blisters that usually go away in weeks. It is much less transmissible than coronavirus and much less deadly than Ebola. There is already an effective vaccine.
What bothers infectious disease experts across the continent is the double standard that has emerged since the monkey’s smallpox caught the world’s attention: few seemed to care, or even realize, until the people of the West began to get sick.
In the last two weeks, cases of the virus transmitted by animals commonly found in West and Central Africa have appeared in the United States, Canada, Australia, Israel and a growing number of European countries. There have been at least 92 confirmed infections and no deaths. Belgium has imposed a 21-day quarantine. President Biden assured Americans that the United States has enough stockpiles of vaccines to deal with the threat.
However, global alarm bells have not rung as several African nations have been battling outbreaks in recent months. Graphics that shine on social media, some of which have been used to illustrate monkeypox since the 1970s, rarely feature white patients.
“These cases are being reported in Europe,” Tomori said. “Why do you use an image of an African? These are your smallpox.”
The World Health Organization has not yet verified the origin of the outbreak, although a WHO adviser told the Associated Press that the cases could be related to radishes in Spain and Belgium. Smallpox is usually spread by close contact, including sexual activity.
Health officials suspect that the virus has been traveling undetected to non-endemic countries for some time, potentially until 2018. Early evidence suggests that the cases come from the West African strain, which the WHO say it has a mortality rate of about 1 percent.
Before monkeypox hit the West this year, the WHO said Nigeria, Cameroon and the Central African Republic had a small number of cases. But contact tracking is limited, said Yap Boum, a Cameroonian epidemiologist. Infections often occur in remote, wooded areas, where people encounter wild animals that carry monkeypox, such as primates and rodents.
“Maybe now that it’s happening there, the problem will get more attention,” Boum said, “and we’ll have access to more vaccines, more treatments, all the things we didn’t have the money for.”
The Democratic Republic of the Congo has been battling the world’s largest outbreak by far: at least 1,238 cases and 57 deaths since January. The strain found there is also much more deadly, with a mortality rate of up to 10 percent. Many deaths can be prevented, doctors said, but it can be difficult to find treatment in areas with poorly funded hospitals.
“It can be as devastating as covid-19,” said Health Minister Jean Jacques Mbungani. But the country’s smallpox smallpox preparations lost strength during the pandemic. The nation needs more tests, more inoculations, more medical workers tracking cases and caring for the sick.
“The response is not effective,” Mbungani said, “and it remains lethargic due to lack of resources.”
As cases of monkeypox increase in Europe and other parts of the world, health authorities are expressing concern about the unusual increase. (Video: Alexa Juliana Ard, Meryl Kornfield / The Washington Post)
The European Center for Disease Prevention and Control said on Monday that most documented cases have been mild. Young children, pregnant women and people with weakened immune systems face a higher risk.
One of Nigeria’s top genomic sequencing experts, Christian Happi, invites his counterparts to study how his country has handled monkeypox.
“It’s not so scary here,” he said. “People are used to it. Come and learn from our public health authorities. Come see how we contain it. “
Global enthusiasm for fighting the virus should have arrived sooner, he said. Maybe it could have been eradicated.
“Paying attention to the disease wherever it goes benefits everyone,” he said. “As the pandemic has shown us, we are all together.”
Ombour reported from Nairobi.