Monkeypox is not a global health emergency so far, WHO says

Monkeypox is not yet a global public health emergency, the World Health Organization said on June 25.

The decision is made because the outbreak of smallpox-related illnesses continues to spread, at least influencing it. 4,100 people in 46 countries As of June 24th.At least for this 201 cases in the United States.. According to the US Centers for Disease Control and Prevention, these cases have been found in 25 states and the District of Columbia.

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“Controlling the further expansion of the outbreak requires intensive response efforts,” the situation should be reassessed within a few weeks, and the WHO Commission will assess the outbreak. Said in the announcement..

Declaring a public health emergency may facilitate treatment and access to vaccines for people infected or exposed to the virus. Some medicines and vaccines that may help dodge monkeypox are approved for use against smallpox and can only be used against monkeypox with special permission.

The virus that causes monkeypox, probably a virus that mainly infects rodents, is named after its discovery in monkeys in 1958, but it is not a new threat. In Central African countries where monkeypox is endemic, it has occurred sporadically since researchers discovered the first human case in 1970. In West Africa, there were few cases until 2017. Most cases outside the continent were travel relatedSpread to others is limited (SN: 5/26/22).

“Monkeypox has been endemic in many African countries for decades and has been ignored in terms of research, attention and funding,” WHO Director General Tedros Gebreyes announced the decision. Said in a statement. “This needs to change not only for monkeypox, but also for other neglected diseases in low-income countries, as the world reaffirms that health is an interrelated proposition.”

Monkeypox usually kills less than 10 percent of people with monkeypox.at least One died With a worldwide outbreak.

As the number of cases increases, researchers are working to decipher the genetic blueprint of the virus, revealing whether mutations in the virus can explain why the virus quickly gained a foothold in new locations. I want to do it.

Mutation tracking

The closest known relatives of the virus version behind the global outbreak come from Nigeria, suggesting that the outbreak may have started there.

In the latest surge in cases, scientists have discovered more viral changes than expected. Perhaps a sign that the virus may have been undetected and circulating among people for some time since the outbreak of monkeypox in Nigeria in 2017-2018. In addition, a group of enzymes known for their ability to fight viruses in the body can be attributed to many of these mutations.

Genetic analysis of monkeypox viruses involved in the global outbreak from 15 people in 7 countries showed that these viruses There are over 50 genetic adjustments on average Researchers will be on June 24th than the versions in circulation in 2018 and 2019 Nature medicine.. This is about 6-12 times the number that scientists expected the virus to develop in the meantime. Unlike other types of viruses, poxviruses, including smallpox and monkeypox viruses, usually mutate fairly slowly.

According to researchers, this change has a pattern that is characteristic of an enzyme family called APOBEC3. These enzymes edit the components of DNA (represented by the letters G, C, A, T) in a specific way. Gs changes to As and Cs changes to Ts. Analysis revealed a specific pattern of viral sequences, suggesting that APOBEC3 is responsible for the mutation.

Ideally, so many DNA building blocks are replaced with another building block that effectively destroys the virus and cannot infect any more cells. However, the APOBEC3 enzyme may not make sufficient changes to knock out the virus. Such mutated viruses, while still functioning, can infect additional cells, and perhaps another person.

But the big question is whether the genetic tweaks found in the monkeypox virus are useful, harmful, or have no effect on the virus.

It is still unclear whether the enzyme is directly involved in the changes in the monkeypox virus, but the team found that similar mutations were still occurring. Therefore, APOBEC3 may be helping the virus change as the virus continues to spread. One member of the enzyme family is found in skin cells where people with monkeypox can develop infectious smallpox lesions.

Various symptoms

Symptoms reported in global outbreaks are generally milder than those reported in previous outbreaks, and the disease may spread before one knows that a person is infected.

It is not clear whether these differences in symptoms are associated with changes in the virus, Inger Damon, director of the CDC’s High-Results Pathogens and Pathology Department, said on June 21. News briefing Sponsored by SciLine, a service for journalists and scientists sponsored by the American Association for the Advancement of Science.

In previous outbreaks, flu-like symptoms such as fever, headache, myalgia, and malaise usually appear about 1 to 2 weeks after exposure to the virus. One to three days after the onset of symptoms, a rash containing a large lesion with pus on the face, limbs, and especially the hands appears and spreads throughout the body. Although generally mild, these symptoms resemble smallpox, but people with monkeypox are also more likely to develop lymph node swelling.

All patients who developed in the United States had a rash, Damon said. Feet. “Instead, the rash can begin in areas of the genitals or anus that can be mistaken for sexually transmitted diseases such as syphilis and herpes, she said.

Often, the rash does not spread to other parts of the body. And classic early symptoms, such as fever, are “mild before the onset of the rash and sometimes absent,” Damon said.

Monkeypox is transmitted from person to person through close skin-to-skin contact or contact with contaminated towels, clothing, and bedding. It can also be spread by drops of saliva exchanged during kisses and other intimate contacts. The CDC is investigating whether the virus can spread through semen and skin-to-skin contact during sexual intercourse, U.S. Public Health Service captain Agam Rao said on June 23, CDC immunity. It was stated at the meeting of the Chemical Implementation Advisory Committee. ..

“There is no reason to doubt that it is spreading in other ways,” Lao said.

In Nigeria, more cases of monkeypox have been recorded among women, but global outbreaks primarily affect men, especially men who have sex with men. Experts warn that anyone can get monkeypox and some people are facing an increased risk of serious illness. People at high risk include children, people with immunodeficiency, pregnant women, and people with eczema.

In the United States, the risk of catching monkeypox by accidental contact is still low, Lao said. However, the data she presented show that while people in the country suffered from monkeypox while traveling abroad, the cases have spread to the local area.