(⊙_⊙)
A daily article on global humanities and geography
WeChat public account: Earth Knowledge Bureau
NO.2222 - What is monkeypox
Author: Zi Yu
Draft: Chao Qian / Editor: Yakult
Since May 7, the World Health Organization has repeatedly issued reports that more than 100 cases of human infection with monkeypox virus have been found outside Africa, covering more than a dozen countries on three continents. After the news spread Chinese the Internet, it once rushed into the top five of the hot search list, surpassing the heat of the Russian-Ukrainian war.
Monkeys who fled the U.S. lab in January this year were quickly associated with monkeys suspected of having been in contact with local residents; some time ago, the U.S. lab discovered the virus of unknown origin, and various conspiracy theories have spread.
A truck carrying experimental monkeys was in a car accident during transport
Four monkeys were on the run, and three were captured and euthanized
(Photo: WNEP)▼
Whereas monkeypox virus is a close relative of smallpox virus. Since the last case of smallpox cured worldwide in the last century, countries have generally stopped vaccinated against smallpox. If the monkeypox outbreak is indeed related to the smallpox virus, it will be a disaster for human society.
However, the source of the epidemic and the chain of transmission are not fully clear, and it is not necessary to be too nervous until the final findings are found, and it is especially important to overcome the fear of monkeypox.
A few days ago, the number of monkeypox cases in Western countries▼
What is monkeypox
In 1958, a mysterious disease with skin blisters as the main symptom broke out among a group of monkeys transported from Africa to Copenhagen, Denmark, and a completely new virus was extracted from the sick monkeys and named monkeypox virus. Follow-up studies have found that monkeypox virus is a double-stranded DNA virus in the genus Orthopellae in the poxviridae family.
In fact, this naming is not accurate, the main animal host of the monkeypox virus is actually rodents. So far, the virus has been found in a variety of animals, including squirrels, and monkeys just happen to carry the pot.
Cynomolgus monkeys are associated with lesions after infection with monkeypox virus
(Landscape, photo: researchgate.net)▼
In August 1970, a 9-year-old child in the village of Bukenda, now part of the Democratic Republic of the Congo, developed smallpox-like symptoms and was laboratory diagnosed with monkeypox virus. This is the world's first clearly documented case of human infection with monkeypox virus.
Given that at that time, people were making every effort to eradicate smallpox, and different types of positive pox viruses had similar genetic and antigenic characteristics, being infected with any kind of positive pox virus could produce resistance to other positive pox viruses. For example, vaccinia virus vaccination can prevent diseases such as severe smallpox, mild smallpox, and cowpox.
As a result, monkeypox infection in humans has long been considered a rare self-limiting disease that has not attracted much attention since its discovery in the 1970s.
Skin slices collected from monkeys infected with monkeypox (Photo: CDC)▼
After 1978, countries gradually stopped vaccinating smallpox, especially among young people, who had not been vaccinated against smallpox, and people's resistance to various positive pox viruses was weakening year by year. In fact, the frequency and geographical distribution of human monkeypox cases in recent years have indeed shown a clear upward trend.
Especially in West and Central Africa, where humans and wildlife are in close contact, monkeypox has been recognized as a serious public health threat.
Poverty and disease have always plagued the people here
▼
At present, it is believed that the clinical manifestations of monkeypox are similar to smallpox, but the symptoms are mild, and the incidence and case fatality rate are generally not as serious as smallpox. After infection with monkeypox virus, the incubation period is about 5 to 21 days.
Symptoms then begin to appear and last about 2-5 weeks. At the onset of the disease, the disease does not have typical features, and patients generally experience symptoms such as fever, headache, drowsiness, weakness and fatigue, lymphadenopathy, back pain, and muscle pain.
The monkeypox virus can cause harm to multiple organs in the human body
In rare cases, sepsis can also occur (Picture: CDC)▼
Within 1 to 5 days of fever, a rash of varying sizes begins to appear on the face of the patient, which then spreads to the trunk, hands, feet, and throughout the body. The rash goes through several stages of development, from macules, papules, blisters to pustules, and then gradually scabs over time. It is possible for different stages of the rash to appear at the same time.
Although monkeypox is far less dangerous than smallpox, the mortality rate of Monkeypox in Central Africa can reach up to 10% (in contrast, the mortality rate of Monkeypox in West Africa is 1%), which is still a serious threat to the safety of human society.
Skin lesions caused by monkeypox (below: nejm.org & CDC)▼
Monkeypox outbreaks worldwide
Monkeypox has not been well known in most countries outside of Africa for quite some time, and many people had never heard of the virus before the current monkeypox outbreak.
It is also true that from 1976 to 2003, only a few dozen cases of human monkeypox were reported in various countries, all of which were located in a few countries in Central and West Africa.
The monkeypox virus under the electron microscope is full of weirdness
（图：UK Health Security Agency）▼
It wasn't until 2003 that monkeypox appeared in the United States across the Atlantic. Monkeypox viruses spread rapidly after landing in the United States, with six states reported in Illinois, Indiana, Kansas, Missouri, Ohio and Wisconsin.
The researchers determined that the outbreak was caused by the monkeypox virus in the West African branch. Epidemiological findings suggest that the virus was introduced to the United States in the spring of 2003 with nine different species of small mammals, including six African rodents.
After the monkeypox outbreak, the flow was eventually traced back to a pet store
It was the animals the store bought from West Africa that carried the monkeypox virus
(Photo: outbreakobservatory.org)▼
But after that, there were no more indigenous monkeypox outbreaks in countries such as Europe and the United States. Even sporadic cases can be traced back to a history of travel to Africa.
For example, in September and October 2018, most of the several cases of human monkeypox reported in the UK and Israel were recent trips to Nigeria, where monkeypox was experiencing an outbreak. In addition, one patient in the UK contracted the disease while caring for other cases, suggesting that monkeypox can be "human-to-human" to some extent.
Therefore, monkeypox is not a new virus that has appeared in the past two years. The reason for the widespread panic caused by this round of the epidemic is that it has spread widely and the number of cases has increased significantly compared with the past. U.S. experts are said to believe that the infectivity of the monkeypox virus has increased significantly compared to before.
The West African branch can be said to have blossomed across the ocean this time
In the context of the sweeping of the world by Omicron, another highly contagious infectious disease has been killed, which really worries many people.
However, it should be noted that since the 21st century, there has also been a significant increase in the number of cases of monkeypox infection in people native to Africa. This may be due to the lack of vaccination against smallpox, or it may be due to the overexploitation of primary forests in Africa in recent years, which has led to a sharp increase in the frequency of human-wildlife contact.
Wildlife should only be seen from a distance, especially avoiding contact with marmots and armadillos
The former carries the plague fungus, while the latter may carry Mycobacterium leprosy
(Photo: Shutterstock & i.cbc.ca)▼
How should we respond
Wave after wave, wave after wave. All kinds of viruses are coming, as if they are scenes only in doomsday movies, but the emergence and spread of monkeypox will be investigated by professional medical institutions. Whether the virus has mutated and led to increased infectivity also needs to be studied by professional institutions. At present, the number of cases is still small, and it has not yet affected China, so we do not have to panic too much.
While monkeypox can infect a variety of animals, its exact host remains to be determined. Not only that, but the way monkeypox viruses are transmitted to humans is not well understood, and its mechanism has yet to be studied. Primary animal-human infection occurs through direct (contact, bite or scratch) or indirect contact when in contact with monkeypox-infected animals.
Keep your hands shut, don't pet wild animals; keep your mouth shut and don't eat wild game
(Photo: cna)▼
Even though "human-to-human transmission" has been reported in the past, there is no evidence that monkeypox virus can spread widely from person to person, and the basic number of infections (R0) of monkeypox virus is thought to be only 0.6 to 1.0.
With no specific treatment for monkeypox, supportive care, symptomatic treatment, and treatment of secondary bacterial infections remain mainstream. Prevention is therefore particularly important.
Prevention is an important means of prevention and control of infectious diseases
This is particularly true in Africa, where medical resources are already extremely scarce
(Photo: timesofmalta.com)▼
First, preventing the spread of monkeypox in monkeypox-endemic areas is challenging, not only by avoiding contact with rodents and primates, but also by limiting direct contact with blood and undercooked meat. Second, getting the smallpox vaccine is a good choice. It is estimated that the smallpox vaccine provides 85% cross-protection against monkeypox infection.
Furthermore, isolation of confirmed and suspected cases and epidemiological investigations, and tracing close contacts can effectively cut off the chain of transmission. Finally, accelerate the development of monkeypox vaccines, but this will take time to conduct controlled clinical trials to assess the safety, efficacy, etc. of the vaccine.
Monkeypox patients admitted to U.S. hospitals (photo: newsbeezer)▼
To date, the clinical and public health features of monkeypox have not been fully understood. The spread of monkeypox across Africa over the past decade and the current outbreak in countries such as Europe and the United States have shown that monkeypox is no longer a rare disease that occurs mainly in remote areas such as Central and West Africa, close to tropical rainforests.
The spread of monkeypox on an international scale needs to be paid enough attention to. We need further research to understand how viruses persist in nature and to explore pathogen-host connections, the impact of climatic and ecological factors, and the impact of viruses on human society.
Humans have been battling viruses since ever
Monkeypox viruses are not the first, nor will they be the last
(Photo: shutterstock)▼
Nietzsche once said that when you gaze into the abyss, the abyss also gazes at you. After all, human beings are only a part of nature, and it is the long-term solution to fear the power of nature and live in harmony with nature.
Resources:
[1] Petersen E, Kantele A, Koopmans M, et al. Human Monkeypox: Epidemiologic and Clinical Characteristics, Diagnosis, and Prevention. Infect Dis Clin North Am. 2019. 33(4): 1027-1043.
[2] McCollum AM, Damon IK. Human monkeypox. Clin Infect Dis. 2014. 58(2): 260-7.
[3] Reynolds MG, Doty JB, McCollum AM, Olson VA, Nakazawa Y. Monkeypox re-emergence in Africa: a call to expand the concept and practice of One Health. Expert Rev Anti Infect Ther. 2019. 17(2): 129-139.
[4] Damon IK. Status of human monkeypox: clinical disease, epidemiology and research. Vaccine. 2011. 29 Suppl 4: D54-9.
Gong Zhenyu, Gong Xunliang. Overview of emerging monkeypox outbreaks in West and Central Africa, 1970-2017. 2018. 33(06): 531-532.
[6] NetEase, beware! Monkeypox cases have occurred in many countries, which belong to the same genus of positive pox virus as smallpox, a viral zoonotic disease, 2022-05-21, 11:20:07 Released.
[7] Dr. Lilac, multinational reports of human monkeypox cases of monkeypox infection with these 6 questions you need to know, 2022-05-20 21:59 released.
*The content of this article is provided by the author and does not represent the position of the Earth Knowledge Bureau
Cover: shutterstock
END