Monkeypox Virus: There was an outbreak of 71 cases of monkeypox in the United States in 2003. (File)
The World Health Organization has revealed that there are now 131 confirmed cases of monkeypox and 106 more suspected cases in 19 countries. Experts describe the event as “random” but “containable” and was probably initially caused by sexual activity in recent radishes in Spain and Belgium.
However, with the world still collapsing due to the effects of the covid pandemic, the rise of a different disease is putting many people on the brink.
Bobby Ghosh of Bloomberg Opinion hosted a live Twitter Space discussion with Bloomberg Intelligence senior pharmaceutical analyst Sam Fazeli to learn about the disease and find out if we need to worry.
Bobby Ghosh: Let me start by asking the most basic question possible: what is monkeypox?
Sam Fazeli: Apparently, there are countless viruses circulating in nature. This is one of them. It is an orthopoxvirus, like other diseases known as chickenpox and smallpox. Smallpox is less problematic than smallpox in terms of mortality. The virus currently circulating appears to be the endemic strain in West Africa.
We have known two strains for a few decades. Both are endemic to different parts of Africa – Central Africa and West Africa, respectively – and specific cases have been reported outside the African continent, usually by someone traveling from an affected area. This outbreak seems quite unusual, as cases are being reported in so many different parts of the world at once. What is happening?
In fact, there was an outbreak of 71 cases in the United States in 2003, not because of a person traveling, but because of rodents imported from Ghana. Those rodents infected prairie dogs, which then infected people. At that time there was the possibility of some local transmission, but it was certainly transmitted from animals to humans. This is a problem we are dealing with in many of these viral outbreaks, from bird flu to covid.
As for today’s unusual outbreak, we need to be aware that it is too early to be sure whether the virus has actually spread separately in different countries or whether at least most cases are from a broadcast event. . The best way to find out how cases are related is to sequence them. The first genome was published by Portuguese scientists and they found that the virus appears to be quite close to the virus that was found in several countries in 2018 and 2019. This already indicates that it has not necessarily changed much. While all of this is pending review, it suggests that we hope to find that most of these cases are actually related.
By the way, it’s worth unpacking that even though it’s called monkey pox, it doesn’t really come from monkeys. We only started paying attention when the monkeys started catching him. Does it originate with apes now? What do we know about how the disease is transmitted?
Orthopox viruses, especially monkeypox, are considered generalists. This means that this virus can infect and infects several species. Rodents are the most common vehicles of infection, then they jumped on monkeys and now on humans. Transmission can occur relatively easily, not necessarily by a specific route. In this case, the view is that it is transmitted through contact with contaminated fluids from an infected person and should be relatively close contact.
Most of the transmission is likely to occur when you are very close to someone who has the virus, so pick up their exhaled drops or be in physical contact with them. It can also be transmitted by fomites, touching a surface that an infected person has touched.
There have been some reports suggesting that it happens mainly through intimate contact, including close proximity or having sex with a person.
I think we have to be very careful not to misinterpret the conversation and the information that comes out. That most cases have been found in men who have sex with men means nothing when it comes to sexual transmission. Let’s just look at how this particular spread occurred. It could easily have been any other kind of intimate contact, heterosexual or whatever.
What are the symptoms of monkeypox?
It starts with a headache and fever, the usual things you deal with when you have a viral infection. These symptoms are basically the activation of your defense system. Many viruses do not like higher temperatures, so the body raises its temperature. We have headaches and muscle aches due to all the chemicals, such as cytokines, that are released to fight the infection. Then, in a week or two, some people have a rash that turns into pustules.
If you are covered in these pustules, you are at risk for bacterial infection and, in some cases, sepsis. Hence the lethality.
There have been no deaths so far in this particular cluster. The mortality rate of 1-3 per cent or the mortality rate of 10-13 per cent of the Central African strain has been widely mentioned, but it should be remembered that, like covid, it depends on how patients are cared for. . If a patient is at home with no oxygen available, no ICU, no medical professionals caring for him, his risk of death is higher. This may be the situation in rural Africa where these figures have been calculated, but in countries with good health care and medicines, I am sure that the mortality rate will remain below 1% – 0%, with good luck!
The symptoms remind me of my childhood when I had chickenpox. I was in bed for several days and I remember it was very uncomfortable. Then he left.
Do we have any idea if chickenpox is more painful or more threatening than chickenpox?
It is a much more uncomfortable infection if you have full pustules on your skin, but it varies. I’ve heard of a case where someone was infected who had previously been vaccinated against smallpox. They had only one or two injuries, which is nothing. That’s the decent thing to do, and it should end there. The question is about people who are not vaccinated. How bad do they get it?
I grew up in India in the 70’s and 80’s and as a child I was vaccinated against smallpox. Smallpox was then eradicated and vaccines were no longer given in many countries.
Does that make us more vulnerable to monkeypox?
Yeah Al that sounds pretty crap to me, Looks like BT aint for me either. It was suggested that perhaps covid confinements increased our susceptibility to disease. It could be said that for influenza and coronavirus, both respiratory viruses. Really in this case, I think it’s just a coincidence. We have an endemic virus in Central and West Africa that has since been given the opportunity to spread among a population of people who have never seen an infection or a vaccine that protects them from the virus.
The good news is that the vaccine already exists, unlike covid. We have vaccines that work both prophylactically and after we have contracted the disease.
So can they be both preventative and curative?
Right, a few days after a diagnosis of infection, it looks like the vaccine still does the job. The interesting thing is that both vaccines can be made today. Stocks may not be as high as you would like in situations like this, but many countries have already been stockpiling them, not for fear of smallpox, but for fear of a smallpox bioterrorist attack.
The disease is less communicable than covid, not everyone needs to be vaccinated. You can use it to treat people who are being diagnosed and to vaccinate those around them. This method is called ring vaccination and has been shown to be successful in controlling smallpox.
There was a lot of discussion about whether poor countries could afford covid vaccines. Is it a problem for smallpox vaccine vaccines?
The Pfizer covid vaccine cost $ 15 to $ 20 per vaccine. For most of us living in England, Sweden, or the United States, this is not expensive given the protection it offers you. I hope that in order to better control and manage the global spread of this virus, the COVAX equivalent will buy vaccines for countries that cannot afford it. At the same time, the cost is clearly determined by the volume. If we only need one million doses, as opposed to 400 million doses, companies will probably have to charge a little more because the margins will be lower on such volumes. I don’t expect it to be a very expensive vaccine.
This is reassuring. How did leaders respond to the monkey’s smallpox? President Biden was forced to answer a question during his trip abroad to South Korea. Have we learned things from our fight against covid at the political level that are especially helpful in dealing with monkeypox?
The best part is, as we’ve said, it’s not a disease we’ve never treated before, even though it’s not necessarily the living memory of many people. It was only about 50 years ago that we stopped smallpox vaccination programs. Bavarian Nordic, one of the manufacturers of a smallpox vaccine, seems to have already had meetings with health authorities in several countries in recent days, which were arranged six months ago. This shows that the countries were already thinking about it: it doesn’t really matter if it was more smallpox than smallpox from the monkey they were thinking about.
Is there any reason to think that monkeypox is seasonal?
At a time of year when people are more outdoors than indoors, most infections, especially respiratory infections, are expected to decrease. This is transmitted by contact. So I don’t think we can classify it as seasonal.
What about variants, which have been a real problem with covid? The monkeypox virus has shown some signs of developing new variants that …