EXPLAINER: What you need to know about Monkeypox

By Carlos Manuel Eusoya

Ever since its detection in various parts of Europe, the Monkeypox virus has caused widespread concern among health experts and common citizens. The virus, which was discovered initially in the African region, has resulted in previous small-scale outbreaks, such as in the 2003 Midwest outbreak located in the United States. Considering that the world has just entered two years of the COVID pandemic, the sudden reappearance of monkeypox is quite alarming.

PHOTO: Inquirer.net

While the rise in potential monkeypox cases is concerning, awareness is still the key to preventing a widespread outbreak. Here are the up-to-date details that you need to know about monkeypox.

The Origins

Closely related to the variola virus (causing smallpox) and the cowpox virus, Monkeypox belongs under the umbrella of Orthopoxviruses. This family of viruses cause zoonotic infections. Zoonotic means that a disease can be transmitted from an animal to a human, and vice versa.

As its name suggests, Monkeypox originated from a colony of monkeys kept for research. In 1958, researchers noted that a rare and unusual disease was slowly spreading across the monkey colonies, and the disease had similar effects to the smallpox virus. By 1970, the very first human case had been recorded in the Democratic Republic of Congo (DRC), during a time where smallpox was also prevalent.

Decades after, monkeypox has been “contained” in the rural and rainforest localities of African countries, such as Gabon, Liberia, Nigeria, and DRC. In fact, it has been declared endemic across these nations. When a disease is considered endemic, it means that the disease occurs naturally, but its spread is kept at a minimum and moderate level.

Although experts have not fully traced the first event “linked to the spread”, the most probable cause behind the outbreak of monkeypox across countries outside the African regions is that the travelers from these non-endemic countries traveled to the endemic areas, contracted the virus, and transmitted the disease on their return.

As of May 24, government agencies have reported that there are 21 cases in the United Kingdom, 30 in Spain, 23 in Portugal, 5 cases in Canada, and potentially “a few more cases” across the United States and Europe. The DRC has reported a total of 1,238 cases and 57 deaths. Excluding DRC and minor African nations, Business Today estimated that at least 92 cases of Monkeypox have been recorded and verified.

The Mechanism of Infection and Transmission

According to the World Health Organization (WHO), there are two common methods of transmission for the monkeypox virus.

The first is zoonosis; i.e. animal to human or human to animal. Squirrels, Gambian pouched rats, and dormice were previously recorded as “natural hosts” or carriers of the virus. Direct contact with blood, fluids, and lesions of  these carriers can pass the virus. Until today, experts are still updating the list of animal species that are capable of transmitting monkeypox. Some medical professionals even advised citizens to properly distance themselves from animals for safety precautions.

The second mode of transmission is human-to-human. Respiratory droplets (cough and sneeze), as well as fomites (objects that are contaminated with the virus) can transmit monkeypox. Mother-to-fetus and sexual intercourse were also considered as pathways for the virus, but WHO and other health agencies are still further studying whether the virus can be transmitted via the aforementioned pathways.

Various symptoms of monkeypox have been listed, but the WHO has compiled these infection symptoms in two steps.

The first step occurs within the first five days. Similar to smallpox and cowpox, the patient may suffer from fever, back pain, headaches, and muscle aches, due to the virus entering the body.

The second step (skin eruption) occurs next, and may last from a few days to a week. Rashes pop up across the patient’s skin, including the face, hands, soles of feet, genitalia, and the eye cornea.

The Outbreak and Discoveries

The 2022 outbreak is still ongoing, and more and more insights from experts come to light as further studies are done in the subject of monkeypox. So far, two current discoveries from the medical field are worth noting.

First, a high percentage of the virus is spreading among members of the LGBT community, although the virus can also spread among other gender orientations. “Anyone, anyone, can develop [and] spread monkeypox infection, but… many of those affected in the current global outbreak identified as gay and bisexual men,” says CDC chief medical officer Dr. John Brooks.

Second, the current mortality rate (percentage of people who die from monkeypox) is at 3-6 percent, but the case fatality rate is far higher for young children. Children are the most vulnerable age group for the disease.

The Preventive Steps

There is no guaranteed treatment for monkeypox, although treatment for smallpox is generally advised for monkeypox patients as well. This includes smallpox vaccine, antivirals, and vaccinia immune globulin (VIG).

The WHO has also emphasized that there is no urgent need for a mass vaccination against monkeypox; following preventive measures can still help one avoid the virus. Similar to COVID-19, one should simply avoid isolated patients, wear personal protective equipment (PPE), and practice good hygiene (e.g. washing of hands). The CDC has also suggested avoiding sick animals for further precaution.

While health organizations continue their in-depth studies, UN agencies have already started assessing the virus’s “threat level”. Nations are preparing emergency management teams, as well as monitoring alerts from neighboring European countries. Agencies have urged the general public to be wary of monkeypox misinformation, similar to the misinformation spread about COVID-19, and asked them to “avoid panic”.

“I think people are a little bit more on edge because of COVID. I think there’s concern because this is something that hasn’t been seen for many years in the U.S. and now it’s popping up in a lot of countries. That dynamic, the time course and the reports from different countries is a little troubling,” says Harvard School of Public Health professor Phyllis Kanki.

One thing’s for sure: nations are bracing for impact if ever monkeypox will further spread. Many of us have already learned the lesson from our arduous experience with COVID-19, and the health sector hopes that the world will apply these lessons for monkeypox.

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