The Paper's reporter Sen Ning
Overseas network
On May 18, local time, the U.S. Centers for Disease Control and Prevention (CDC) said in a statement that the agency is working with Massachusetts health officials to investigate a case of monkeypox.
Massachusetts health officials earlier announced that a man who had recently visited Canada had been confirmed to be infected with monkeypox. This is also the first confirmed case of monkeypox in the United States in 2022.
Dr. Paul Biddinger, the relevant person in charge of Massachusetts General Brigham, said at a press conference on the 18th that the patient was admitted to Massachusetts General Hospital for examination on May 12 for suspected symptoms, because the disease is very rare. The hospital and the CDC took 6 days to diagnose him, and the man is currently in stable condition. Public health authorities are identifying people who may have been in contact with the man during his infection.
Bitinger said they were not yet sure how the patient was infected, had no travel history to areas with high monkeypox, had no contact with animals and was more likely infected through close human-to-human contact.
He stressed, "Historically, this is a very rare disease, and it is very rare to spread around the world." He said there is currently "no public health risk" for the patient and that people should "be aware of the symptoms but don't be afraid." ”
Still, Jennifer McQuiston, a senior official at the Centers for Disease Control and Prevention, told health news site STAT on Tuesday: "We do have a certain level of concern, which is very different from what we usually think of as monkeypox."
In the past two weeks, confirmed or suspected cases of monkeypox have been reported in the United Kingdom, Portugal and Spain. As of 18 May, the UK has reported 9 confirmed cases, the first of which was confirmed on the 6th; Portugal has reported 5 confirmed cases, all of whom are young men, and more than 10 suspected cases; and Spain has reported more than 20 suspected cases, all of which are male.
According to the Centers for Disease Control and Prevention, the virus can also spread from person to person through respiratory droplets, which typically occur in closed environments.
The sudden surge in cases has drawn the attention of public health professionals around the world. On Wednesday, the World Health Organization said it would send an accident team to Britain to respond to the outbreak.
Susan Hopkins, chief medical adviser to the UK Health Safety Agency and epidemiologist, said in a statement on Monday: "This [outbreak] is rare, very unusual."
Japanese media: Monkeypox virus may be transmitted from person to person, and there is no treatment for it
Japanese media analysis said that monkeypox virus has the possibility of human-to-human transmission, and there is no treatment at present.
According to reports, when humans are infected with monkeypox virus, symptoms such as fever, sore throat, and swollen lymph nodes will occur, and when severe, a large-scale rash will appear on the face and body. In addition to the transmission of the virus from animals to humans, there is also a possibility of human-to-human transmission, but the transmission routes are limited. At present, although there is no treatment, it has been determined that the smallpox vaccine also has a preventive effect on monkeypox.
Shigeru Morikawa, a virus expert at Okayama University of Science in Japan, said that people who have not been vaccinated against smallpox, have underlying diseases, and have low immunity are more likely to have severe monkeypox. In addition, monkeypox viruses do not spread through droplets like the new crown virus, and the chance of global spread is very small. However, in areas where outbreaks occur, care needs to be taken to avoid touching wild animals.
Monkeypox virus microscopy image (infographic)
Is sexual transmission the main route?
Monkeypox is a rare infectious disease with a virus similar to the smallpox virus that has been eradicated in humans today.
The main carriers of the monkeypox virus remain unclear, and some scientists suspect that rodents or small mammals in Africa play a role in the spread. In parts of Central and West Africa, people may be exposed to the virus through bites or scratches from rodents and small mammals, preparation of wild prey, or exposure to infected animals or animal products.
Previously, cases of monkeypox were mostly found in Africa, while cases that appeared outside Africa were often associated with travel there. For example, the United States detected two cases of monkeypox in Texas and Maryland in 2021, both of which were confirmed in the United States after patients had traveled to Nigeria.
The World Health Organization has previously said that monkeypox is usually not easily transmitted from person to person. However, the virus can be transmitted through contact with items such as bodily fluids, monkeypox, or clothing and bedding contaminated with the virus. According to the Centers for Disease Control and Prevention, the virus can also spread from person to person through respiratory droplets, which typically occur in closed environments.
"In general, the spread of monkeypox viruses from person to person does occur through close contact. Examples include close contact through respiratory droplets and prolonged face-to-face contact, as well as direct contact through lesions, or through contaminated bedding or clothing contaminated to some extent by lesions," Dr. Sarimer Sanchez, director of the Infectious Diseases Division of the Boston Public Health Council, said in an interview with CBS.
The Centers for Disease Control and Prevention said in a latest press release that the agency is tracking multiple monkeypox clusters reported over the past two weeks that occurred in several countries that don't normally report monkeypox, including Portugal, Spain and the United Kingdom. "It's unclear how these populations came into contact with monkeypox, but the cases include some people who claim to be males who have had sex with men."
"Many reports of monkeypox cases worldwide occur within sex networks." Dr. Inger Damon, director of the Pathogens and Pathology Division at the U.S. Centers for Disease Control and Prevention, said in a press release. But the U.S. Centers for Disease Control and Prevention also said monkeypox has not been recognized as a sexually transmitted disease, but it can be spread through close contact with infected people, their bodily fluids, clothing or bed sheets.
It has also been reported that 7 of the 8 cases in the UK have not recently traveled to Africa, suggesting that the patients in these cases are infected with the virus in the UK. The UK Health Security Agency reported on May 17 that the men had no contact with a patient known to have been to Nigeria. The agency said the country's latest cases "occur mainly among men who are gay, bisexual or have sex with men."
Mateo Prochazka, an epidemiologist at the UK Health Safety Service, wrote on Twitter: "It is strange that we have found cases that appear to have acquired infections through sexual contact. This is a new route of transmission that will have an impact on outbreak response and control. ”
Meanwhile, British epidemiologist Hopkins said in a statement from the Health Security Agency: "We specifically urge lesbian and bisexual men to be aware of any unusual rashes or injuries and to contact health services immediately."
How dangerous is monkeypox?
According to the U.S. Centers for Disease Control and Prevention, the monkeypox virus was first identified in a population of monkeys for research purposes in 1958. In 1970, the first human case of infection with the virus was detected in the Democratic Republic of the Congo. Today, most monkeypox infections still occur in Central and West Africa.
Monkeypox usually begins with flu-like symptoms and lymphadenopathy, which are usually similar to smallpox but milder than smallpox symptoms. Early symptoms include fever, muscle pain, chills, and fatigue. In more severe cases, rashes usually appear on the face and genitals, similar to chickenpox and smallpox. Foci of pain and itching can form throughout the body and eventually become scabs and shedding.
People infected with monkeypox usually begin to develop symptoms 7 to 14 days after infection, and the condition usually lasts for several weeks. Both the World Health Organization and the U.S. Centers for Disease Control and Prevention declare that "while most people can recover from the virus, in some cases it can be dangerous and even fatal." ”
So far, scientists have identified two forms of the virus: the West African branch and the Congo Basin branch. The West African branch has a lower lethality rate, with about 1% of infections resulting in death. The World Health Organization says the Congo Basin branch can cause up to one in ten deaths among infected people.
Dr. Anne.W. Rimoin, a professor of epidemiology at the Fielding School of Public Health at UCLA, said in an interview with USA Today that while the data are preliminary, the current outbreak appears to be linked to a less deadly branch of West Africa.
Jimmy Whitworth, an international professor of public health at the London School of Hygiene and Tropical Medicine, said in an interview with Reuters that the number of infections and deaths from the virus may not reach covid-19 levels.
"This will not cause a global epidemic like COVID-19, but it is a serious outbreak of a serious disease that we should take seriously," Whitworth said.
What else do we need to be wary of?
In 2003, the monkeypox virus was transported from Ghana to Illinois in the United States along with a boat of animals. The Centers for Disease Control and Prevention said on its website that several giant cystic rats and squirrels tested positive for the virus and eventually spread the virus to prairie dogs sold as pets in several Midwestern states. 47 people contracted the disease from prairie dogs and rats. However, there was no human contagion at that time.
In 2019, the U.S. Food and Drug Administration approved the first monkeypox vaccines, which also protect against smallpox. The vaccines are available as part of the U.S. National Strategic Reserve (SNS). In addition, several antiviral drugs also seem to be effective. But the U.S. Centers for Disease Control and Prevention also said there is no proven, safe treatment for monkeypox virus infection.
Rimoin, who has extensively studied monkeypox and other infectious diseases in Central Africa, said in a 2017 interview with Npicarius that the monkeypox virus may have infected people for centuries, if not millennia. But for a long time, doctors ignored these cases.
Monkeypox virus is closely related to smallpox virus. "They are clinically indistinguishable," Rimoin said. "So for centuries, doctors probably mistook monkeypox for smallpox."
By the 1970s, humans had almost eliminated the smallpox virus. Doctors in Central Africa began to notice another disease that looked like smallpox, but it did not spread from person to person as smallpox. This is monkeypox. ”
In 2010, Rimoin and her colleagues reported a 14-fold increase in monkeypox cases in the Democratic Republic of the Congo since the 1980s, with the incidence rising from less than 1 case per 10,000 people to about 14 cases per 10,000 people. According to a study published in February, there were nearly 4,600 suspected cases in Congo in 2020.
Scientists believe that ironically, the reason for this is the eradication of smallpox. The smallpox vaccine is a great protector against monkeypox, and its effectiveness is about 85%. (Although the smallpox vaccine does have some safety concerns, as the smallpox vaccine is a live virus that can cause fatal infections in people with severely deficient immune systems.)
But after the world eradicated smallpox, countries stopped vaccinateing children against smallpox. Jay Hooper of the U.S. Army's Institute of Infectious Disease Medicine said in the same interview on National Public Television in 2017 that for those who were vaccinated against smallpox a few years ago, the vaccine's protective effects could diminish over time.
"There's more and more people who aren't immune to monkeypox right now," he said, "and when there's a real outbreak, it could be bigger, and as the virus spreads from animals, you never know what's going to happen." ”
This new outbreak in Europe could be a sign that the virus has changed – even just a little – and could enhance its ability to spread among people.
Senior Editor of this issue Xing Tan