The headlines reporting a recent outbreak of monkeypox, usually confined to Central and Western Africa, have brought back echoes of early 2020, with fears of a new pandemic spreading like wildfire. Monkeypox is a viral zoonosis (a virus transmitted to humans from animals) with symptoms very similar to those seen in the past in smallpox patients, although it is clinically less severe. As more and more cases are confirmed across the globe, should countries be bracing themselves for the next pandemic?
Key Takeaways:
- Over 3,400 confirmed cases of Monkeypox have been reported by the World Health Organization, from 50 countries across five regions, since January 2022, with one-third of these (1,300) being reported since June 17.
- WHO is working with the affected countries and others to expand disease surveillance to find and support people who may be affected, and to provide guidance on how to manage the disease.
- Monkeypox is less contagious than COVID-19 and influenza, with experts predicting it will not be the next big global pandemic as there are counter drugs and vaccines available to fight against it.
What do you think sparked the latest viral outbreak from animals to humans?
“Around half percent of all well-known human infections are zoonotic and experts believe that their rise is due to an increase in population growth, livestock growth, encroachment into wildlife habitats, and many more. I strongly agree with many scientists and specialists that climate change affects the risk of major pandemics. The central tipping point is destroying the natural habitats of different species who might interact with each other or humans and keeping generations of pathogens inside them – silently circulating, especially in the mammals of tropical rainforests.”
“To start, this disease is not caused by an unknown agent, like SARS-CoV-2 was at the time, but by a well-studied distant relative of the smallpox virus that has been known since 1958. The bad news is that, if left untreated, monkeypox has a mortality rate of 3%-10%. There has been plenty of time to understand how it spreads and even work out which drugs it is sensitive to. It is even known that the smallpox vaccine (which most adults over 50 received when they were kids) offers good protection. There are more positive facts. Contagion happens only in very close-contact situations and, contrary to what we’ve seen with COVID-19, patients can infect others only once they have symptoms. Avoiding intimacy with those with a suspicious rash or fever cuts your risk of catching it greatly. That’s why monkeypox outbreaks are usually small and controllable. It’s a poorly transmitted disease. It can be caught from infected animals too, usually rodents (monkeys got the bad rap for historical reasons but are not the most common reservoirs), although this is rare in urban environments. The current outbreak is different. For the first time in history, it spans over 30 countries and includes 658 cases, as of the time of writing. So far, there are no reported deaths so at least there’s a silver lining. There have been outbreaks before (including one with over 70 cases in the US in 2003 due to imported Gambian pouched rats) but none of this magnitude, so widespread and so difficult to trace. It seems that patient zero may have been a Brit who traveled to Nigeria and perhaps got the virus from a wild animal, but the chain of transmission quickly gets blurred after this.”
“Though rare and usually mild, monkeypox can still potentially cause severe illness. This is not the first time we have seen this large number of cases. Following its first description in 1958 in monkeys at a pet store in Copenhagen, the first case of transmission to humans was detected in 1970 in Central Africa. In 2003, an outbreak was also observed in the United States with 71 cases recorded in Texas. In 2017, Nigeria experienced an outbreak. Several cases then appeared in the United Kingdom, among other places.”
“Epidemics that spread from animals to humans are called zoonoses. Whether it is domestic or wild animals, everything is linked to the contact between the two. In my opinion, climate change is at the root of this state of affairs, especially with regard to contact with wild animals in a context where each species has to go beyond the usual places for its subsistence.”
Is monkeypox the next big pandemic? Argue your position.
“There is an opinion saying that since monkeypox cases have been registered in non-endemic areas, this has maximized the possibility of another global health crisis after COVID-19. Being a healthcare professional, I cannot agree with that. Why? Coronavirus was novel, while monkeypox isn’t new to the world. Monkeypox is less contagious than COVID-19 and flu. In my opinion, it’s not going to be the next big global pandemic as we have counter drugs and vaccines available to fight against it. We know through history and developing clinical patterns what measures for behavioral risk communication and community engagement should be taken into consideration and it can be controlled at a local and international level well in time.”
“The first explanation that jumps to mind would be that the monkeypox virus acquired a new mutation that made it more infectious like we’ve seen happening to SARS-CoV-2 many times in these past two years. But this doesn’t seem to be the case because the sequencing of the viral genome has so far revealed no major changes; it seems to be identical to the viruses that roam Western Africa (which, incidentally, are the less lethal of the family, with a mortality rate of only 1%). There could be a new way of spreading it: sexual contact. This has not been reported before but with the fact that sexual relations usually need people to be in close proximity, it may just be a coincidence. A more worrying hypothesis that is being considered is that COVID-19 has “primed” us for other diseases. Two years of severely reduced exposure to pathogens (due to lockdowns, social distancing, masks, and hand washing) could have weakened our immunity, making us more prone to catching microbes that previously were kept in check. What now? The monkeypox outbreak is likely to die out in a relatively short time due to the characteristics of transmission discussed earlier. It may do so without leaving mortal victims if we keep the same rate. Now that the general public is aware (and often afraid), it will be easier to avoid risky situations. Vaccines and drugs should further reduce serious events. But the main question is, are we going to see rarer infectious diseases jumping into the spotlight in the next months as a remote side effect of the pandemic? Is one of them going to be truly problematic on a worldwide scale? Let’s hope the answer is no.”
“Health officials are concerned that more cases will arise with travel increasing over summer. Monkeypox is unlikely to cause another pandemic but with COVID-19 at the front of our minds, the fear of another major outbreak is understandable. Like the coronavirus, the monkeypox virus can be transmitted from animals to humans when there is proximity. While an animal reservoir for the monkeypox virus is unknown, rodents are suspected to play a part in transmission. Unlike the coronavirus, the transmission of the monkeypox virus is very difficult and requires physical contact (skin-to-skin contact) including sexual contact. It is for this reason that each time the virus has appeared, the epidemic has died out quickly. In addition, the immunity acquired after infection protects against the disease for life. Thus, the monkeypox virus cannot cause an epidemic especially since it is a DNA virus that does not mutate easily (unlike coronavirus which is an RNA virus) and cannot evolve to be transmitted quickly. What is new is the fact of noting several cases of transmission in several countries that haven’t experienced monkeypox before. Most cases are men who have had sex with men but will not necessarily be only exclusive to that group. Because monkeypox is closely related to smallpox, the smallpox vaccine can provide protection against infection from both viruses. Finally, it is possible to resort to a vaccine as for the coronavirus. On the other hand, the vaccination will only be directed towards people who have close contact with carriers of the virus.”
“Monkeypox could be the future great epizootic if the same environmental factors trigger the phenomenon without necessarily spreading from one forest to another.”
How do you characterize the current WHO actions in this matter?
“I believe being a custodian of new health challenges, WHO is closely monitoring and working with countries that are responding to the new outbreak. It is not only sharing new developments to understand more but also releasing new directives to affected countries. WHO is regularly sharing clinical situation updates with a particular focus on safety measures and guidance on vaccination. The world follows the directives of WHO being an independent non-governmental body and the organization supports its Member States with surveillance, preparedness, and outbreak prevention activities for monkeypox in affected countries.”
“The current World Health Organizations actions are adequate since the vaccine that was used for the eradication of smallpox and some other newer vaccines are effective against monkeypox. Remember, as the earth “ages” new illnesses will become frequent.”
“WHO supports the investigations (accompanying governments) but on the response plan, the action is still unknown to the general population and this is due to the fact that the one health approach is poorly developed in most member countries.”
See also: Is monkeypox the next big pandemic? (Part I) | Experts’ Opinions
Check out more than 700 job opportunities in the health sector here.
