On May 7, the World Health Organization (WHO) received a report of a human case of monkeypox virus infection [1] in the United Kingdom after returning from a trip to Nigeria.
Since May 13th, a total of 92 confirmed cases and 28 suspected cases of monkeypox have been reported in 12 countries and regions around the world. WHO believes that more cases may be found in these and other countries in the future [2].
Why does this kind of “pox” that sounds like only monkeys get in humans, should we worry about it?
Globally, human cases of monkeypox occur primarily in Africa.
Monkeypox virus was first discovered in monkeys in 1958. Historically, monkeypox cases have been reported in countries such as Cameroon, Central African Republic, Côte d’Ivoire, Gabon, Liberia, Nigeria and Sierra Leone in West and Central Africa. The worst outbreak is in the Democratic Republic of Congo, with more than 1,000 cases reported annually since 2016 [3].
In 2003, there was an outbreak of monkeypox in the United States, with 71 cases reported [4]. In 2018, 2019 and 2021, monkeypox cases were also reported in the United Kingdom [5].
The recent monkeypox epidemic has affected many European and American countries, such as the United States, France, Germany, Canada, Sweden, Belgium, and Australia. The relatively high numbers of cases are in Portugal, Spain, and the United Kingdom [2]. So far, no monkeypox cases have been reported in my country.
(Countries reporting confirmed human monkeypox cases from 1970 to 2021[2])
Monkeypox spreads in two main ways:
—”close contact” with an infected person or animal
—touching virus-contaminated items (such as an infected person’s clothing, towels, or bedding)
Although the virus can theoretically enter the body through bodily fluids (such as blood), respiratory tract, or mucous membranes (eyes, nose, mouth) to cause infection, monkeypox does not easily spread from person to person spread between. Because respiratory droplets have a certain distance of transmission, the risk of transmission is higher through prolonged face-to-face contact [5-6].
It is worth mentioning that the UK Health Security Agency (UKHSA) specifically proposed “to be concerned about genital lesions”. One of the reasons may be that among recently diagnosed patients, many people voluntarily reported being bisexual or had sex with men [2]. This may be one of the explanations for “close contact”.
Monkeypox is a “zoonotic disease”—in layman’s terms, a species of monkeypox virus that can infect both animals and people.
This is true of many of the viruses we see commonly (like rabies, plague, anthrax, and even Covid-19), as well as the less familiar ones like Marburg, Nipah, Ebola, and more. Of course, different viruses have different transmission and pathogenicity among different animals (people).
Monkeypox virus can infect not only monkeys and humans, but also other animals (such as squirrels, mice, and other rodents). The monkeypox epidemic in the United States in 2003 mentioned above was finally traced to the groundhogs raised with the Gambian kangaroos [7].
Unfortunately, not yet.
From the English name, monkeypox seems to be very similar to chickenpox (chickenpox) and smallpox (smallpox), which has long disappeared. genus”.
Studies confirm that smallpox vaccination is cross-protective against monkeypox virus — reducing the risk of infection and reducing clinical symptoms after infection. This cross-protection may be maintained for decades [8].
However, the world (including ours) eliminated smallpox in 1980 and stopped smallpox vaccination. Older people may have been vaccinated against smallpox, but young people under 40 are generally not immune to smallpox and monkeypox. The “scar” on our left arm is actually left by the BCG vaccination (to prevent tuberculosis infection in infants and young children).
Currently, the European Union has approved a modified live attenuated vaccinia vaccine for smallpox and monkeypox high-risk groups; the United States also retains the live attenuated smallpox vaccine, which was used in 2003 to control the epidemic. However, there is currently no smallpox vaccine widely vaccinated in the population in my country.
As of now, there has been no global outbreak of monkeypox. Based on the available evidence, monkeypox is unlikely to be a global pandemic like the new crown.
Although monkeypox has appeared in many countries, it generally appears in the form of “sporadic” in countries outside Africa, with a scale of no more than 100 people, and disappears within a month or a few months .
However, the CDC is concerned that deforestation and hunting, population movement and climate change, and the consumption of animals such as monkeys and squirrels may contribute to the number of cases in more countries [3] ]. Whether the monkeypox virus will mutate to “easier” human-to-human transmission requires ongoing monitoring and research.
At the national level, measures that can be taken include banning the entry of animals that may transmit monkeypox virus (such as rodents, primates, etc.) Quarantine of tools, people and goods. Medical institutions and disease control departments at all levels should strengthen early warning and monitoring. Once confirmed or suspected cases appear, they should immediately isolate themselves and their close contacts.
On May 22, Belgium announced that it would require monkeypox cases to undergo a 21-day quarantine, the first country in the European Union to require monkeypox cases to be quarantined.
For ourselves, we should avoid contact with animals that may carry monkeypox virus (such as wild or unknown monkeys, rodents, etc.), and do not travel to places with monkeypox outbreaks. country and region. At this stage, wearing masks, maintaining hand hygiene, opening windows for ventilation, and daily disinfection are still very effective preventive measures.
Reverence for life, respect for nature, and protection of wildlife are also the ultimate way for humans to protect and save ourselves.
Contributing Author: Wang Xi
Deputy Chief Physician of Public Health, Minhang District Center for Disease Control and Prevention, Shanghai
References
[1]https:https://news.un.org/en/story/2022/05/1103192
[2]https:https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON385
[3]https:https://www.cdc.gov/mmwr/volumes/67/wr/mm6710a5.htm
[4]https:https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5227a5.htm
[5]https:https://www.gov.uk/guidance/monkeypox
[6]https:https://www.cdc.gov/poxvirus/monkeypox/transmission.html
[7]https:https://www.cdc.gov/poxvirus/monkeypox/outbreak/us-outbreaks.html
[8]Rimoin A W , Mulembakani P M , Johnston S C , et al. Major increase in human monkeypox incidence 30 years after smallpox vaccination campaigns cease in the Democratic Republic of Congo[J]. Proceedings of the National Academy of Sciences, 2010, 107(37):16262-16267.
Editors: Ye Yichu, Zhao Yanan, Ye Zhengxing
Typesetting: Li Yongmin | Operation: Han Ningning | Coordinator: Ye Yichu