Monkeypox, which was originally a rare infectious disease in Africa, has been broadcast to non-monkeypox endemic countries such as Europe, the Americas and Oceania since May 2022. On 7 May, the first case occurred in the UK (outside of Africa), a patient who had contracted the disease in Nigeria and returned to the UK.
There is widespread fear that the monkeypox outbreak will become as uncontrollable as the COVID-19 pandemic and plunge countries back into a prolonged lockdown.
In this regard, Raul Rivas Gonzalez, a microbiologist at the University of Salamanca in Spain, in The Conversation, offered "10 reasons not to worry too much about [the monkeypox epidemic]" now:
1, it is a known virus
Monkeypox was detected in 1958 and there have been two outbreaks of smallpox-like diseases in monkey colonies raised in the laboratory. The first case of monkeypox in humans occurred in the Democratic Republic of the Congo in August 1970. Since then, scientists have studied the virus and closely monitored it.
2, it is a relatively stable virus
Compared to coronaviruses, influenza viruses, or RNA viruses, monkeypox viruses are relatively large DNA viruses that mutate more slowly and mutate systems that are easy to detect and even repair. This means that monkeypox viruses are unlikely to mutate "suddenly" or at a "high rate", making human transmission rates higher or appearing highly variable. This also means that once cured, patients will have "long-term immunity" to the virus.
To date, two gene differentiation branches have been sorted out: West African Branches and Central African Branches. They are geographically separated and have clear epidemiological and clinical differences. DNA sequences show that the virus currently circulating is a mild type of virus circulating in West Africa that is closely related to the species of monkeypox virus detected in the UK, Singapore and Israel in 2018 and 2019.
3, there are already some people in the world with a certain degree of immunity
Monkeypox virus, smallpox virus and cowpox virus are closely related "positive pox viruses". Historical data show that people who have been vaccinated against smallpox are about 85% protective of monkeypox. Smallpox was declared eradicated in 1980, so people who have been vaccinated against smallpox, a large percentage of people around the age of 45 today, are less susceptible to monkeypox.
4) We know how it is contagious
There are no more than three routes of transmission of "zoonotic infectious diseases", one is that humans directly contact the blood, body fluids, mucous membranes or skin lesions of infected animals; the second is the consumption of raw or undercooked meat of infected animals; and the third is that humans are bitten or scratched by animals.
For the "interpersonal" transmission route, it is mainly "close contact with droplet particles, respiratory secretions, skin damage or contamination to the surface of the virus-carrying object"; in addition, the virus is transmitted from the mother to the fetus through the placenta, or, during the baby's birth and in close contact after birth, through the skin, respiratory tract or mucous membrane wounds.
Crucially, we already understand the pathways by which monkeypox viruses spread, so effective preventive measures can be developed.
5, the transmission between people "will not be too serious"
This is the first time monkeypox has occurred in Europe, but it has no epidemiological relationship with West and Central Africa, so "through droplets or contact with infected wounds" is the most likely route of transmission leading to this outbreak.
Most of the cases in Europe are young men, many of whom are same-sex sexual intercourse. Close contact between sexual partners increases the chance of infection due to close contact during sexual intercourse. What is certain is that without close contact, the chance of transmission will be very low.
6. Its clinical manifestations are usually mild
Monkeypox symptoms persist for 2-4 weeks before they naturally improve. Historically, the mortality rate of Monkeypox in Africa is about 0%-11%, but it should be mentioned that monkeypox has a higher mortality rate among young children.
According to african studies, the fatality rate of this West African monkeypox prevalent in Europe to date is about 3.6%. Mortality rates are higher among children, young adults and immunocompromised people, with most recovering within a few weeks.
7. Its symptoms are obvious and unique
Monkeypox virus is easy to trace because it differs from the new coronavirus (SARS-CoV-2) that can spread asymptomatically. Because of the skin damage it can cause, monkeypox patients are often difficult to ignore. Symptoms such as monkeypox fever, severe headaches, swollen lymph nodes, back pain, muscle aches and weakness can also help diagnose and detect infected people.
From the first day to the third day of the fever, a unique rash appears on the skin. The rash occurs on the face (95% of cases), palms, and soles of feet (75% of cases), as well as the oral mucosa, genitals, conjunctiva, and cornea.
The rash develops from the initial "puffy spots" to "slightly raised papules, blisters filled with transparent fluid, pustules with a yellowish liquid", and finally the scab falls off. The number varies from person to person, with a minimum of a few and a maximum of several thousand.
8. The detection method is fast and effective
In many laboratories in Europe, the Americas and Africa, we can detect monkeypox virus from potentially infected skin lesions through real-time polymerization chain reactions, using test strips to wipe scabs or outflows of fluid sampling without the need for blood samples.
Timely PCR nucleic acid detection can not only distinguish monkeypox viruses from other positive acne viruses, but also distinguish between two different differentiated branches of monkeypox (West Africa and Congo).
9. Vaccines are effective
The first generation of smallpox vaccines against the cowpox virus has long since ceased to exist, but the second and third generations of vaccines that have been developed are enough to help humans fight smallpox and monkeypox.
The Danish active attenuated vaccine "Jynneos", now named "Imvanex" by the European Union and "Imvamune" in Canada, is the third generation (smallpox) vaccine that contains the modified Ankara cowpox virus (MVA-BN) – which cannot replicate in the human body but can trigger immunity to fight smallpox and monkeypox.
The Jynneos vaccine is the only monkeypox and non-replicating smallpox vaccine approved by the U.S. Food and Drug Administration (FDA) for non-military use.
10. Antiviral drugs are very effective
In vitro experiments and animal studies, both drugs, cidofovir and Brincidofovir, are active against pox virus. Bulsidofovir is a potent inhibitor of DNA polymerase capable of dealing with a variety of double-stranded DNA viruses, such as monkeypox viruses.
Tecovirimat (ST-246) is also effective in treating diseases caused by positive pox virus, and clinical trials in humans have shown that this drug is safe, highly tolerated, and has few side effects. Tecovirimat is a good treatment for children and adults (weighing at least 13 kg) infected with cowpox, monkey pox and human smallpox.
Raul Rivas Gonzalez, a microbiologist at the University of Salamanca in Spain, hopes that the current outbreak "can be contained without the need for a lockdown policy other than vaccination".
But he also pointed out that despite the above good news, people must still remain vigilant and cautious, because there are still many unsolved mysteries about monkeypox - for example, this monkeypox is "quietly spreading", the number of cases has increased very suddenly, and each outbreak can be traced back to several simultaneous sources of infection... (if there is no other reason), it is most likely caused by a "mutation".