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The speed of the global spread of this round of monkeypox epidemics and the unusual transmission path are rare.
In Europe, scientists are still sequencing the genome of the latest monkeypox virus in intense progress.
According to the surging news, as of now, the latest 9 monkeypox virus gene sequencing reports from France, Italy, Spain, the Netherlands, Belgium have been released, researchers said that the analysis of the existing monkeypox virus genome sequence shows that the virus belongs to the mild West African branch, the relationship between virus samples is extremely close, further confirming that monkeypox has appeared in Europe has a large-scale community transmission.
Two carnival parties in Europe may be the main cause of monkeypox spreading
The World Health Organization has confirmed that more than 300 confirmed and suspected cases of monkeypox have been detected in around 20 countries around the world since the first monkeypox patient was detected in the UK in early May. Most cases are in men who have had sexual relations between men.
According to the Associated Press reported on the 24th, Who infectious disease expert David Heymann believes that the recent outbreak of monkeypox is a "random event" that may be related to sex in two large-scale parties in Spain and Belgium.
Andrea Ammon, director of the European Center for Disease Control and Prevention, also analyzed that the possibility of further transmission of the virus through close contact, such as sex with sexual partners, is high.
Multinational health officials sounded the alarm for June
According to the surging news, the Italian research team said that according to the information currently available, most known cases of monkeypox occur mainly but not exclusively in men who have sex with men, and the confirmed pathologies are manifested as perianal and genital lesions, and a few skin lesions have a synchronous evolutionary pattern.
And June is coming next week. June is the "pride month" of global minorities (gay, bisexual, non-gender, transgender, etc.), and a series of parades are usually held around the globe. Against this backdrop, health officials around the world are working to raise awareness of the spreading monkeypox outbreak.
Demetre Daskalakis, director of the HIV/AIDS Prevention Division at the U.S. Centers for Disease Control and Prevention, said, "In fact, the message we send to all communities is similar, and if there is an unusual rash, it may be monkeypox, be vigilant," Daskarakis said. ”
In previous cases, monkeypox is not considered a sexually transmitted disease like AIDS, and to date there is no evidence that the monkeypox virus is transmitted through semen or vaginal secretions. In this outbreak, there have been multiple reports of genital or penile injuries in infected people. Therefore, if one party is infected, close contact during people's sexual activity may lead to transmission.
Anne Rimoin, a professor of infectious disease epidemiology at UCLA, sees the outbreak as "worrisome," not "alarming." She said it remains to be seen how much serious illness it will cause if the monkeypox virus spreads among people living with HIV. But she stressed that the current situation deserves attention.
Will it cause a coronavirus-style pandemic?
A few days ago, virology experts, Professor Jin Dongyan of the School of Biomedical Sciences of the University of Hong Kong pointed out in an interview with the 21st Century Business Herald reporter that the monkeypox virus is a large molecule "old virus", unlike the new crown virus, it is easy to mutate, from the past situation it can not become a global pandemic, and there are drugs, there are vaccines, if there is a need for Chinese biology, there is a vaccine (Tiantan Biology once had a smallpox vaccine business, but it has been transferred to Chinese biology in 2017), and the detection technology is also very mature, and there is no need for relevant screening at present. The capital market is purely speculative.
Mostly from sexual transmission?
Monkeypox virus and smallpox virus are close relatives, both of which are positive pox viruses. In 1980, the World Health Organization announced that smallpox had been eradicated worldwide, and monkeypox is considered the most important positive pox virus infection in humans since smallpox eradication. Prior to the current outbreak, monkeypox cases were sporadic in tropical rainforests in central and western Africa.
According to an article published on May 21 by the official WeChat public account of the Department of Infectious Diseases and The Department of Infectious Diseases of Huashan Hospital affiliated to Fudan University, the name of the "monkeypox" virus comes from monkeys, but the real source of monkeypox virus is not monkeys. In nature, many animal species have been found infected with the monkeypox virus. Some evidence suggests that native African rodents, such as Gambian giant rats and squirrels, may be reservoirs for the virus.
The "Huashan Infection" tweet noted that human-to-human transmission of monkeypox virus is uncommon. When it does occur, it is mainly transmitted through droplets, which can infect the mucous membranes of the eyes, nose and throat, which studies have shown to require long periods of face-to-face contact to spread. For example, in the absence of personal protective equipment, it lasts for more than 3 hours within a 2-meter radius. However, it can also be transmitted by contact with lesions or body fluids, or by contact with clothing or linen products contaminated with pus or other damaging substances.
WHO also notes that available information indicates that human-to-human transmission is occurring in people in close physical contact with symptomatic cases. Claire Dausnapp, president of the British Sexual Health and AIDS Association, said in an interview with the media on May 22: "The number of confirmed cases is likely to be high in the next two to three weeks. ”
According to WHO, recent cases of monkeypox in many European countries are "atypical", these cases do not have a clear travel history in monkeypox endemic areas, and many infected people have been confirmed by STD clinic examinations, mainly but not limited to men who have sex with men. To date, all cases of samples confirmed by PCR have been identified as west African evolutionary clades infected with the virus.
More contagious?
The genomic sequence of swab samples from confirmed cases in Portugal suggests that the monkeypox virus that caused the current outbreak closely matched the cases exported from Nigeria to the UK, Israel and Singapore in 2018 and 2019.
However, William Hanach, an epidemiologist at Harvard University, believes that although the strains currently spreading globally "appear to be closely related to the strains that spread in West Africa in 2018", more research is needed. "It's definitely behaving differently because (spreading) is much broader. It's clear that something different has happened, and the reasons for this discrepancy are not yet clear. The monkeypox strain currently circulating in at least 11 countries appears to be more contagious, and the basic number of regenerations (R0) of monkeypox may be greater than 1 as the global outbreak continues to erupt on an unknown scale. ”
However, Hanaki also put forward another view: "When people start looking for cases of infection, so much is found, which shows that the virus is not spreading very quickly, but has been around for a while, and the number is relatively large." ”
Jin Dongyan also pointed out to the 21st Century Business Herald reporter that monkeypox cases have been increasing since the routine smallpox vaccination stopped. It is also understood that some researchers have systematically reviewed a large number of studies and data on the epidemiological evolution of monkeypox in the past 50 years, pointing out that people's immunity to smallpox virus has declined, creating conditions for the "resurgence" of monkeypox.
However, there are also some concerns, and there are reports that the current rate of detection of monkeypox infection cases suggests that the virus has undergone a major shift in behavior and has the ability to spread from person to person without being noticed. Jason Jindrachuk, a Canadian virus expert who has studied monkeypox, said: "Global transmission is worrying, and this is not the monkeypox virus habit we know as well. What we are seeing now is unprecedented. Cases have occurred in multiple regions of the globe, what is the epidemiological link between these cases? Is there anything related to changes within the virus? ”
Won't cause a pandemic?
As for whether it will cause a pandemic, Jin Dongyan believes that it will not be at all.
Jin Dongyan pointed out to the 21st Century Business Herald reporter that as early as 2003, there was an outbreak of monkeypox in the United States, but it did not cause a major epidemic and was limited to small-scale transmission. It is far less contagious than the new crown virus. After the vaccination of pox vaccines was stopped in 1980, monkeypox occasionally infected people, but its transmissibility and pathogenicity were relatively poor viruses.
"Monkeypox is less transmissible from person to person, and its pathogenicity is not as good as smallpox virus, and the overall risk is not large." The main transmission route is also droplet transmission, contact transmission, pox damage after the virus carries, sexual transmission methods are relatively small, the transmission effect is very low, it is impossible to continue human-to-human transmission, and the transmission between people is not effective enough, which is the main feature of this virus. The virus is a 200 kb DNA virus, not easy to mutate, a smallpox virus has only one serotype, monkeypox is only 2-3, and can not be effective in human-to-human transmission, persistence is not good. Jin Dongyan pointed out.
Michael Head, a senior researcher in global health at the University of Southampton in the United Kingdom, also said that a large-scale monkeypox outbreak in developed countries is very unlikely, "there will be no new coronavirus-like transmission speed." ”
There is currently no specific vaccine for monkeypox. But the smallpox vaccine provides some cross-protection against monkeypox. According to the U.S. Centers for Disease Control and Prevention (CDC), the smallpox vaccine could also protect humans from monkeypox viruses because the two viruses are closely related.
African data cited by the WHO shows that the smallpox vaccine is 85% effective against monkeypox virus. According to the US CDC, smallpox vaccination can be given after exposure to monkeypox, the earlier the better, and the best time to vaccinate is within 4 days from the date of exposure.
According to overseas networks reported on May 21, after the United States reported the first case of monkeypox infection this year, there were reports that the U.S. health department had ordered millions of doses of monkeypox vaccine worth $119 million. On May 18, Danish vaccine company Bavarian Nordic issued a statement saying it had signed a multi-hundred-million dollar contract with the U.S. Biomedical Advanced Research and Development Agency (BARDA). The U.S. government's contract with the company totals $299 million and will provide 13 million doses of lyophilized monkeypox vaccine, with the first vaccines expected to be delivered in 2023, the statement said.
For the test, Jin Dongyan pointed out that it is completely unnecessary. If you need to do specific testing, you can collect samples to do PCR This is a very mature, ready-made laboratory technology and methods, if you do test reagents there is no market, there is no need to do screening, which is only limited to capital speculation.
Source: 21st Century Business Herald (Zhu Ping), The Paper, China News Network
Editor of this issue is Feng Zhanpeng
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