Description | Summary of monkeypox outbreaks

So far: Monkeypox is a rare viral infection that was primarily restricted to some countries in West Africa and Central Africa and travelers to these countries, and is flooded with zoonotic diseases. The disease has spread internationally in more than 16,000 cases in more than 75 countries and is caused primarily by human-to-human contact, primarily gay, bisexual and MSM (men who have sex with men). ) Has spread to the community. On July 23, 2022, with the proliferation of monkeypox cases worldwide, Dr. Tedros Adhanom, director of the World Health Organization (WHO), declared the outbreak of the disease a Public Health Emergency of International Concern (PHEIC). Did.

What is monkeypox? What is the cause of the illness?

First discovered in monkeys at the Statens Serum Institute in Denmark in 1958, monkeypox is a zoonotic virus that infects humans as well as other animals, including rodents and other primates. There is a possibility. Since the first human case was identified in 1970, the virus has been prevalent in parts of Central and West Africa today, mainly caused by the spillover effects of zoonotic diseases in the Democratic Republic of the Congo. Despite being labeled “monkeypox,” it is misnamed in many ways because the actual cause and cause of the disease is unknown. This virus belongs to the same virus family as Bariola, the virus that causes smallpox. The disease presents with symptoms similar to those previously seen in smallpox patients, but is less contagious and less severe.

Symptoms of monkeypox include fever, headache, muscle aches, drowsiness, and common rashes and blisters on the face, palms, feet, mouth, eyes, and genitals. These symptoms usually appear within 2 weeks of infection, but can last 2 to 4 weeks and, in severe cases, occur primarily in children. In most cases, monkeypox is a self-limited illness that resolves spontaneously without specific treatment. However, newborns, toddlers, and the underlying people of immunodeficiency may be at increased risk of developing more serious symptoms.

How does the virus infect?

The virus can be transmitted from both animals to humans and between humans. Animal-to-human transmission of the virus can result from close contact with the blood, body fluids, or skin lesions of the infected animal. Human-to-human transmission can occur through close contact, body secretions, skin lesions, or contaminated items in individuals infected with monkeypox.

Close contact with humans during sexual activity is believed to be the driving force behind the current spread of the disease, as evidenced by the main spread in the gay, bisexual and MSM communities.

How are the current outbreaks different?

Since the first human detection in Africa in 1970, the first outbreak of monkeypox outside Africa was reported in the United States in 2003, with multiple cases associated with close contact with infected imported animals. It turned out to be. Recently, in May 2022, several cases of the disease were reported from areas where monkeypox was not endemic, most of which had traveled to Europe or North America rather than Africa. Prior to the current outbreak, monkeypox was reported primarily from Africa, but all cases reported in patients in other countries were with travel to areas where the disease was common, or with imported animals. It was due to the contact of. At present, no association has been established between these new cases of contact with infected animals. The number of confirmed monkeypox cases increased by more than 70% from late June to early July 2022, with the majority of the case burden in Europe. However, knowledge of the source and transmission route of the 2022 outbreak, and the changes in the virus that helped infect humans more than before, has made monkeypox a major public health disease worldwide. I have.

What does it mean to declare monkeypox a health emergency?

WHO defines PHEIC as an outbreak of illness that “consists of public health risks through the spread of international illness”, which may require a swift and coordinated international response. .. Since 2009, WHO has made seven PHEIC declarations, including the ongoing COVID-19 pandemic. This designation involves accelerating international efforts to contain the epidemic of the disease before it develops into a pandemic. This means encouraging countries to devise efforts to control the transmission and coordinate sharing of critical resources such as vaccines and therapies, apart from contact tracing, diagnostic and vaccination enhancements. increase. While research is underway to understand epidemiology, transmission routes, and clinical manifestations of the disease, WHO has been influenced to develop effective outbreak response and monitoring, and prevention and treatment strategies for monkeypox. Support the country.

There are several favorable factors. First, thanks to African researchers who have been able to contain the outbreak for decades, there is a wealth of information on how to contain the virus and its spread, and how to manage the disease. In addition, thanks to the COVID-19 pandemic, a fairly effective vaccine is available despite logistical problems, along with a widely available infrastructure for molecular diagnostics. Pathogen genome surveillance provides a unique opportunity to track contact networks and assess the continued evolution of the virus. It is encouraging to note that the large number of monkeypox genomes from the current outbreak are available in the public domain, but there are significant differences in numbers from developing countries, especially from Asia, including India.

What are the current prevention and treatment options for monkeypox?

There is no specific treatment available for monkeypox. Clinical management of monkeypox includes symptom relief, complication management, and prevention of long-term effects. It is also currently unknown whether previous monkeypox infections provide protective immunity against future infections. However, the genetic similarity between smallpox virus and monkeypox virus also protects vaccines and antiviral agents used for the global eradication of smallpox from monkeypox. WHO reports that vaccination against smallpox is about 85% effective in preventing monkeypox, so prior immunity to smallpox can lead to mild illness. The original smallpox vaccine is not open to the public, but a new vaccine approved in 2019 has been developed to prevent monkeypox. Research is currently underway to understand the effectiveness and feasibility of vaccination in the prevention of monkeypox.

While the world is discussing the subtle differences in why Dr. Tedros declared Monkey Pox as a global health emergency, despite the Commission’s vote against it almost a month ago, the Earth With warming, efforts for world and ubiquitous world travel, global public health cooperation and resource sharing have had an unprecedented time. As we get out of the pandemic, there is no better time to prepare for new challenges.

The author is a researcher at the CSIR Institute of Genomics and Integrative Biology (CSIR-IGIB) in Delhi.