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Scientists are trying to better understand why the monkey’s smallpox spreads rapidly worldwide in regions that do not normally harbor the disease since the UK confirmed it first case of monkeypox in early May.
“We’ve never seen this kind of observation of monkeypox before, so that’s especially worrying,” said Andrea McCollum, an epidemiologist who leads the poxvirus team at the Centers for Disease Control and Prevention. CDC).
This graph from the Centers for Disease Control and Prevention shows a patient’s hand showing symptoms of one of the first known cases of monkeypox virus. (Courtesy of CDC / Getty Images)
More than 550 confirmed cases of monkeypox have been detected in 30 countries around the world, including approximately 18 in the United States, according to the World Health Organization (WHO) and the CDC.
“We are seeing all the cases appear in a relatively short period of time. We are seeing that in a few days, in a couple of weeks, we are seeing more than 500 cases. This is different. This had not been seen before.” said Rosamund Lewis, WHO technical manager for monkeypox.
The CDC notes that the smallpox of the monkey belongs to it genus of viruses such as smallpoxbut after smallpox was eradicated by global vaccination in 1980, a decrease in smallpox immunity may have contributed to the increase in cases, as smallpox vaccination is no longer recommended, according to Nature.
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Africa usually has a few thousand cases in an average year, most in the central and western parts of the regionbut only last week did cases outside Africa exceed the total number detected outside the continent since 1970, when the first human case was detected.
But while scientists are concerned about the rapid spread of smallpox, there is no coronavirus, according to Nature.
A negative spot electron micrograph reveals a virion of the Mulberry “M” type smallpox virus in human vesicular fluid. (BSIP / UIG via Getty Images)
Smallpox is not as infectious as SARS-CoV-2, the virus responsible Covid-19 pandemicbecause it is not transmitted from person to person with the same ease and because we have vaccines to prevent it, said Jay Hooper, a virologist at the U.S. Army Infectious Diseases Medical Research Institute in Fort Detrick, Maryland.
SARS-CoV-2 is spread through small droplets of air called aerosols, but scientists believe that the monkey’s smallpox is spread mainly through close contact with body fluids, so that a person infected with the smallpox of the monkey will infect far fewer close contacts than someone infected with the coronavirus, Hooper added. .
Research from viral genome sequencing of people infected with monkeypox in Belgium, France, Germany, Portugal, and the United States suggests that the strain of monkeypox resembles the much less lethal strain that is found in West Africa, which has a mortality rate of less than 1% in rural populations. . In comparison, the most virulent strain in Central Africa has a mortality rate of up to 10%, according to Nature.
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These sequences are more similar to the group of monkeypox cases that arose outside Africa in 2018 and 2019 and were related to trips to West Africa.
Therefore, the simplest explanation is that the person who had the first non-African case of the year became infected by contact with animals or by close contact with someone who was already infected with the virus while traveling to a similar region. in Africa, says Bernie Moss, a virologist at the National Institute of Allergy and Infectious Diseases.
Researchers hope to find out if the rapid increase in cases is due to a viral mutation that allows the smallpox to be transmitted more easily, says Dr. Raina MacIntyre, an epidemiologist specializing in infectious diseases at the University of New South Wales at Sydney, Australia.
But unlike SARS-CoV-2, which is an RNA virus that is able to evade vaccine immunity or previous infection, monkeypox is a DNA virus that is known to be better. to repair mutations than RNA viruses. That means the monkeypox virus is less likely to mutate suddenly and make person-to-person transmission easier, MacIntyre added.
But it’s still “deeply worrying” that cases of monkeypox are on the rise in people without a connection to each other, McCollum said.
Scientists are also trying to find out why the case groups mostly include men between the ages of 20 and 50, many of whom have sex with men (MSM), but MacIntyre says it could be a coincidence that the virus has been introduced into a MSM community and continued to expand. as it is not known to be insexually transmitted infection.
The UK Health Security Agency, however, recommends that symptomatic monkeypox patients refrain from sexual activity while injured, although there is no known evidence of the virus in genital excretions. In addition, they recommend the use of condoms for eight weeks after infection.
This graph from the Centers for Disease Control and Prevention shows a patient’s hand showing symptoms of one of the first known cases of monkeypox virus. (CDC / Getty Images)
Although the CDC notes that there is no specific treatment for monkeypox, several antivirals may be beneficial.
In addition, the United States has a reserve of millions of smallpox vaccines, two of which are approved and are generally effective against smallpox as well.
The CDC’s Immunization Practice Advisory Committee recently issued recommendations to limit the use of the Jynneos smallpox vaccine to health care workers and laboratory staff who work closely with the virus.
McCollum noted that these therapies will not be deployed on a large scale, but that close contact of those infected with monkeypox will be vaccinated using a method called “ring vaccination.”
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“The first part is to identify the infected and isolate them and make sure they get the care they need,” said Dr. Raj Panjabi, who leads the response to the smallpox of the White House monkey.
“The second part is to make sure we vaccinate those who have been exposed to infected people. If we do it over and over again, and that’s our focus on the White House and the whole government, we’re more likely to end it. that. sprout. ”