Monkeypox continues to baffle scientists as it spreads to other countries


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Scientists are trying to better understand why monkeypox spreads rapidly around the world in regions that do not usually harbor the disease since the UK confirmed its first case of monkeypox in early May.

“We’ve never really seen these kinds of monkeypox sightings before, so it’s particularly concerning,” said Andrea McCollum, an epidemiologist who leads the poxvirus team at the Centers for Disease Control and Prevention (CDC). ).

In this graphic from the Centers for Disease Control and Prevention, symptoms of one of the earliest known cases of monkeypox virus are displayed on a patient’s hand.
(Courtesy CDC/Getty Images)

More than 550 confirmed cases of monkeypox in 30 countries have been detected worldwide, including about 18 in the United States, according to the World Health Organization (WHO) and the CDC.

“We all see cases appear in a relatively short period of time. We find that in a few days, in a few weeks, we see more than 500 cases. It’s different. It’s never been seen before.”, said Rosamund Lewis, WHO technical lead for monkeypox.

The CDC notes that monkeypox belongs to the same kind of virus like smallpoxbut after smallpox was eradicated by global vaccination in 1980, declining immunity to monkeypox may have contributed to the increase in cases since smallpox vaccination is no longer recommended, according to Nature.

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Africa typically has a few thousand cases in an average year, mostly in the the west and center of the regionbut last week cases outside Africa surpassed the total number detected outside the continent since 1970, when the first human case was detected.

But even though scientists are concerned about the rapid spread of monkeypox, it’s not a coronavirus, according to Nature.

A negatively stained electron micrograph reveals a "M" Mulberry-like monkeypox virus virion in human vesicle fluid.

Negatively stained electron micrograph reveals type “M” monkeypox virus virion in human vesicle fluid.
(BSIP/UIG Via Getty Images)

Monkeypox is not as infectious as SARS-CoV-2, the virus responsible for Covid-19 pandemicbecause it doesn’t spread as easily from person to person and because we have vaccines to prevent it, said Jay Hooper, a virologist at the U.S. Army Disease Medical Research Institute. infections in Fort Detrick, Maryland.

SARS-CoV-2 is spread through tiny airborne droplets called aerosols, but scientists believe monkeypox is mainly spread through close contact with bodily fluids, so a person infected with smallpox monkey will infect far fewer close contacts than someone infected with the coronavirus, Hooper added.

Research on the sequencing of viral genomes from people infected with monkeypox in Belgium, France, Germany, Portugal and the United States suggests that the strain of monkeypox resembles the much less deadly strain found in West Africa , which has a mortality rate of less than 1% in rural populations. By comparison, the much more virulent Central African strain has a mortality rate of up to 10%, according to Nature.

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These sequences are most similar to the cluster of monkeypox cases that emerged outside of Africa in 2018 and 2019 and were linked to travel to West Africa.

So the simplest explanation is that the person who had the first non-African case of the year became infected through contact with an animal or through close contact with someone already infected with the virus while traveling in 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 rise in cases stems from a viral mutation that allows monkeypox to be transmitted more easily, says Dr Raina MacIntyre, an infectious disease epidemiologist at the University of New South Wales in Sydney, in Australia.

But unlike SARS-CoV-2, which is an RNA virus capable of evading immunity from vaccines or previous infection, monkeypox is a DNA virus, known to be more effective at repairing mutations than RNA virus. This means the monkeypox virus is less likely to suddenly mutate and facilitate person-to-person transmission, MacIntyre added.

But it is still “deeply concerning” that cases of monkeypox are increasing in people unrelated to each other, McCollum said.

Scientists are also trying to find out why clusters of cases mainly include men aged 20-50, many of whom have sex with men (MSM), but MacIntyre says it could be coincidence that the virus was introduced in an MSM community and continued to spread. because he is not known to be asexually transmitted infection.

The UK Health Safety Agency, however, advises patients with symptoms of monkeypox to abstain from sexual activity while lesions are present, even if there is no known evidence of the virus in excreta. genitals. Additionally, they recommend the use of condoms for eight weeks after infection.

In this graphic from the Centers for Disease Control and Prevention, symptoms of one of the earliest known cases of monkeypox virus are displayed on a patient's hand.

In this graphic from the Centers for Disease Control and Prevention, symptoms of one of the earliest known cases of monkeypox virus are displayed on a patient’s hand.
(CDC/Getty Images)

Although the CDC notes that there is no specific treatment for monkeypox, several antivirals may prove beneficial.

In addition, the United States has a stockpile of millions of smallpox vaccines, two of which are approved and generally effective against monkeypox as well.

The CDC’s Advisory Committee on Immunization Practices recently released recommendations to limit the use of the smallpox vaccine known as Jynneos to healthcare workers and laboratory personnel who work closely with the virus. .

McCollum noted that these therapies will not be rolled out on a large scale, but that close contacts of people infected with monkeypox will be vaccinated in a method called “ring vaccination.”

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“The first part is to identify infected people, isolate them and make sure they get the care they need,” said Dr Raj Panjabi, who leads the House’s monkeypox response. White.

“The second part is to make sure that we vaccinate those who have been exposed to infected people. If we do that over and over again – and that’s our approach in the White House and across government – then we have a better chance of ending this epidemic.”


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