The United States, together with several non-endemic countries like Canada, Portugal, Spain, and the United Kingdom, have confirmed more than 400 cases of monkeypox. Recently, the Centers for Disease Control and Prevention found that monkeypox cases have been identified and located in several states like California, Colorado, Florida, Massachusetts, New York, Utah, Virginia and Washington. Given this situation, the health alert has been activated, but the health authorities emphasize that the risk of a new pandemic occurring is really low.

What is its origin?

Monkeypox is a rare zoonotic disease, which means that it can be transmitted between animals and humans. The virus belongs to the orthopoxvirus genus, like that of smallpox. Despite its name, monkeys are not its main reservoir, although it was first identified in 1958 in a population of primates. Its origin is unknown, but it is believed to be transmitted by small rodents and squirrels in tropical forests. So far, the incidence has been localized to central and western Africa, where the disease is endemic and thousands of cases occur each year. Outside Africa, before the current outbreak, cases have been documented in the United States, United Kingdom, Israel and Singapore, but all of them were linked to imported cases or to contact with animals from endemic areas. Two different phylogenetic lineages of the virus have been characterized: the one from central Africa, more serious and with more complications; and West Africa, which is less pathogenic. The new outbreak would correspond to this second lineage.

Where have cases been detected?

Currently, confirmed cases have been identified in very diverse countries, none of them endemic, in the first outbreak that occurs in several places at the same time and in which those infected are not linked to trips to Africa. Because it is a pathogen with limited spread, the researchers are trying to find out what is causing this geographical spread of cases.

How is it transmitted?

The monkeypox virus does not spread easily between people and the risk to the population is low. It can be transmitted by the respiratory route, but due to the characteristics of most cases, everything points to contact with fluids. Its transmission takes place through contact with wounds, body fluids, droplets and contaminated material, such as bedding, and its incubation period is usually from six to thirteen days, although it can go up to 21 days.

As detailed by the CDC, contagion occurs if there is contact with those vesicles that come out, similar to those of chickenpox. If when those vesicles are broken, we touch the liquid, we can get it, which is what it seems which has been the mechanism in most of the cases that have been encountered. CDC Director Dr. Rochelle Walensky has also clarified that there may be contagion by droplets, through the respiratory tract, "[but] it is difficult and it has to be a very close contact.” “There is practically no chance of it becoming an epidemic," she reassured.

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Is it a common disease?

Monkeypox is very rare, although the number of cases has increased in Africa in recent years.  The reasons for this increase are not clear, but experts point out that one of the main explanations is that vaccination against traditional smallpox was stopped due to the eradication of the virus, and this vaccine offered cross-protection against monkeypox. very high. In addition, deforestation and increased mobility of people have also led to increased contact between humans and animals that carry the virus. In the United States, it is the first time that a chain of transmission has occurred that is not linked to travel to parts of West and Central Africa.

What are the symptoms?

Monkeypox causes symptoms very similar to those of smallpox, even milder, although it can also cause the death of the patient. The disease begins with a headache, fever, chills, muscle aches, extreme fatigue and, unlike smallpox, swollen lymph nodes. One to three days after the onset of fever, a rash develops, usually starting on the face and then spreading to other parts of the body, including the palms of the hands and soles of the feet.

As in smallpox, the rash begins as red spots, which eventually turn into pustules. After several days, these pustules form a scab, which ends up falling off. Monkeypox usually lasts two to four weeks. The researcher of the Higher Council for Scientific Research (CSIC) Margarita del Val points out that it is a "reasonably benign" disease but it causes "very large and striking lesions" on the skin.

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What treatment is given?

Monkeypox treatment focuses primarily on symptom relief, as there is no medication to deal with the infection. However, the traditional smallpox vaccine, which has not been administered for decades due to the eradication of the virus, has very high levels of efficacy. The US health authorities are considering the purchase of these vaccines, which have also been improved and could serve to prevent monkeypox. In any case, they emphasize that a massive vaccination would not be carried out, but only close contacts.

A pandemic like COVID-19 is not feared

The disease, first identified in monkeys, does not spread easily between people, so experts say the risk to the population is low and an expansion like that of the COVID-19 pandemic is not expected.

To become infected, close contact with infectious material is necessary. It can occur from touching the chickenpox-like skin lesions that appear in infected people, but also through contaminated objects. Currently, there is no specific vaccine for monkeypox, but data shows that the vaccines used to eradicate smallpox are up to 85% effective against monkeypox, according to the World Health Organization (WHO).

References: 

1. “2022 United States Monkeypox Response and Recommendations | Monkeypox | Poxvirus | CDC.” Www.cdc.gov, 26 May 2022, www.cdc.gov/poxvirus/monkeypox/response/2022/index.html.

2. ‌“The CDC Has Identified 10 Monkeypox Cases in the U.S. Here’s What We Know so Far.” NBC News, www.nbcnews.com/health/health-news/us-monkeypox-cases-identified-rcna30388. Accessed 29 May 2022.

3. “Monkeypox Cases Investigated in Europe, US, Canada and Australia.” BBC News, 20 May 2022, www.bbc.com/news/health-61506562.