Worst scenario of monkeypox: another syphilis

First report of Cases of monkeypox in Europe It began to surface in mid-May. After a week, 92 confirmed Outside Central and West African countries where the disease is usually endemic.now There are 1,200.. Who knows by the end of this month? “If I asked me two weeks ago, I expected thousands of cases worldwide to occur in connection with this current outbreak,” said Weill Cornell Medical College, a professor of population health. One Jay Varma told me. .. “But I’m much more pessimistic.”

To be precise, where is the outbreak heading?When I ask five experts their predictions, they will certainly say only one thing: monkeypox No Next COVID-19. Not only is it not contagious enough to cause an infection on a pandemic scale, it does not look like a particularly deadly virus. (To date, none of the 1,200 patients have died.) But beyond that, their views were widespread. Or it can be a modest, intermittent problem. Or it can turn into an ever-present risk and inconvenience, such as the following genital herpes. The three routes that monkeypox can follow are:

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Rose scenario: Quick fizzle

This is not the first time monkeypox has invaded the United States.at least 47 people Infected with the virus in 2003 after interacting with infected pet prairie dogs in six states (It is legal to own In most states! ).Spread is It contains Within a few months, and no one died. The two became seriously ill, but recovered.

Read: I should have seen monkeypox coming

This time the prairie dogs are not involved. Most, if not all, cases of monkeypox in the United States this year appear to be due to human-to-human contact.As a result, dealing with public health becomes more complex. Euthanasia Animals that may be infected, as authorities did in 2003. Immunization can rapidly suppress the spread, Ameshua Dalha, a senior scholar at the Johns Hopkins Center for Health and Security, told me. After all, there is a stockpile of smallpox vaccine in the United States, which can also counter this outbreak. (Exact size of stockpile Remain unclear.. “Monkeypox is a containable virus,” he told me.

The 2003 outbreak, in part, Ring vaccination, All close contact with infected patients will be inoculated. This works because of the physical proximity required for monkeypox infection, contact tracing of monkeypox is relatively easy, and vaccination of recently infected individuals can transmit monkeypox. Because you can prevent it from happening. Adalja predicts that ring vaccination could outweigh the epidemic of monkeypox in the United States within a few weeks, with cases going to zero within about three months.

Medium scenario: sporadic problems

Monkeypox has already occasionally occurred in Central and West Africa. According to experts, this is because the virus is endemic to local animal populations, perhaps certain mammals. The same can happen here in the United States. If a sufficient number of American wildlife is infected by interaction with infected humans, monkeypox can circulate in silence after zero human cases. From time to time, an animal infects a person, who spreads the virus to some close contact, forming another small outbreak and then disappearing. Repeat indefinitely.

Bhargavi Rao, who worked in the Democratic Republic of the Congo and the Central African Republic as Head of Emerging Infectious Diseases for Doctors Without Borders, told me that a series of monkeypox infections “doesn’t overwhelm the community.” rice field. She said she believes that the risk of monkeypox epidemics in animals outside Central and West Africa is “very low,” but if so, the effects would be similar to those of modern times. Anthrax, RabiesAlso bird-fluThat is, it can occasionally cause confusion and occasionally lead to animal selection, but it generally does not affect daily life. (James Diaz, director of environmental and occupational health at Louisiana State University, told me that monkeypox may already be endemic to American wildlife, but there is solid evidence to support this claim. do not have.)

However, the fact that many recent cases have been recorded in and around large cities can lead to different results. In the country where Lao worked, the disease prevails mainly on farmers and bush hunters who live in communities isolated from wildlife. She said there is no way to know how big the outbreak will be in the big cities of the United States, even though those at risk generally have better access to tests and vaccines. If the outbreak is large enough, the virus can become endemic in a rodent population and even cause an outbreak in urban areas. “There is nothing you can do when it’s in a mouse,” Adalja told me.

Bad scenario: another syphilis

If you can’t stop the current outbreak, address a completely different issue. Both Rao and Adalja are unlikely to have such results, as monkeypox patients are generally non-infectious before symptoms appear and the world has already been tested, vaccinated, and treated for the virus. Said.However, conventional knowledge about monkeypox May not be retained Because of this outbreak. Varma, who helped lead New York City’s response to COVID, is far more worried than the other experts I’ve spoken to. “I think we have less than a 50 percent chance of containing this,” he said.

That does not mean that one-third of the country is likely to have monkeypox within the next six months. Balma predicts that monkeypox will continue to circulate at low levels and continue to concentrate on the male community having sex with men. (For clarity, monkeypox is not a sexually transmitted disease. The CDC states:High numberSo far, there have been cases involving men having sex with men, but the disease can be spread by sexual or non-sexual contact. ) Then, the monkeypox will be as follows. syphilisAccording to Balma, this affects about 0.04% of Americans, most of whom have sex with men. In Balma’s absolute worst-case scenario (which he considers unlikely), monkeypox has spread to all types of communities, including children and pregnant women. Genital herpesMore than 12 percent of Americans are infected.

Jim Downs: Gay men need specific warnings about monkeypox

Again, this does not mean the collapse of civilization. Few people die of monkeypox or become seriously ill. Even if monkeypox spreads among Americans, regular vaccination can eliminate many of the risks associated with people’s health, Adalja told me. However, the more people get sick, the more likely it is that someone will experience rare and serious complications.Population-wide vaccination may also have some potential Disadvantage..

We also don’t know how the illness will change. DNA viruses, including monkeypox, are generally stable and slowly evolve into new strains. But “it’s never a good thing to spread the zoonotic virus to humans without checking it,” Bogma Titanji, an infectious disease specialist at Emory University, told me. “In reality, we don’t know what the virus’s adaptation to the new host will do.” It can be more or less contagious and cause more or less serious illness or death. Or it could stay almost the same.

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No one can accurately predict the future of this outbreak until we are convinced of the present. And we aren’t there yet.Of the virus Incubation period It takes an average of 1-2 weeks, but can be as long as 3 weeks. So what we’re seeing now is a reflection of the virus’s spread many days ago.We are not so test Titanji told me it was enough to track the outbreak.

Examination is especially important because cases of current outbreaks look very different from classic monkeypox. Historically, monkeypox lesions first developed around the tongue and mouth, followed by rashes on the face, arms, and legs, which progressed to the lesions. Those symptoms were easy to see. However, recent outbreaks include many patients with only a handful of lesions that are concentrated around the genitals and anus. In the past, cases of monkeypox in the United States were related to travel, and sick people appeared at travel clinics and told doctors that they were abroad. Currently, patients may appear in genital clinics and investigate private scabs. The more accessible the test, the easier it is to advise to identify and quarantine the patient, but the vaccine will be provided to the contact. “The sooner you get an infection confirmed in the laboratory, the more people take it seriously,” Balma said.

So far, it is not yet known how many people are infected nationwide and how many will eventually get sick. When I asked Titanji to know how and when we were on which path, she said it was difficult to say and not worth guessing. She says, “Every time a virus crosses a species and invades a new species and itself infects and causes an outbreak, you are in the gray zone.”