Impending Lockdown? Experts warn public due to uncontained Monkeypox outbreak

By Chris Armand Santiana

On Thursday, infectious disease doctor and virologist Boghuma Titanji at Emory University in Atlanta warned the public of ‘losing the window to be able to contain the Monkeypox outbreak’ during a seminar sponsored by Harvard Kennedy School’s Belfer Center for Science and International Affairs.

Photo courtesy of The Moscow Times and Hot Lifestyle News

World Health Organization Director (WHO) Tedros Adhanom Ghebreyesus has also declared that the global outbreak is already a public health emergency of international concern, and placed WHO’s highest state of alert. Although the WHO committee reviewing the situation was divided on whether the outbreak counts as an international emergency, Ghebreyesus determined that sufficient conditions existed to support the designation.

Starting the month of May, more than 15,700 people have been infected of the said virus; 2,800 cases have been reported in the United States, as of Friday according to the U.S. Centers for Disease Control and Prevention report. 

“Although I am declaring a public health emergency of international concern, for the moment this is an outbreak that is concentrated among men who have sex with men, especially those with multiple sexual partners,” Ghebreyesus said in a statement. “That means that this is an outbreak that can be stopped with the right strategies in the right groups,” he added.

According to Anne Rimoin, an epidemiologist at the UCLA Fielding School of Public Health, monkeypox outbreaks have been a continuing issue in some regions of Africa for many years. Monkeypox "has been giving us warning signals" for years in Congo, Nigeria, and other parts of West Africa, but has only received attention since it recently started causing cases outside of the continent, according to Rimoin. However, the virus "has been neglected by the global health community."

Furthermore, there has been no concerted global effort to contain the virus, Titanji said. Irregularities have resulted from the outbreak. Testing, vaccinations, and treatments that may help lessen the severity of the illness are only available in well-resourced nations. Nations with lower resources lack access to these health facilities and tools, which limits their capacity to monitor or manage the infection. 

According to Jay K. Varma, director of the Cornell Center for Pandemic Prevention and Response in New York City, continued monkeypox transmission in resource-poor nations could make areas that do manage to contain an initial epidemic vulnerable to reintroductions. The WHO's declaration of an emergency may spur a more coordinated worldwide effort and increase the amount of funding available to stop the virus's spread.

However, the outbreak may still prove to be difficult to contain, even for the wealthiest countries. There are many unresolved questions regarding the virus's mode of transmission and the efficacy of vaccinations and treatments, when available. Even the diagnosis of the illness might be challenging because testing kits are frequently difficult to obtain and missed diagnoses could result in more instances.

In the global outbreak, men who have intercourse with other men have accounted for the vast majority of cases of monkeypox. 98 percent of the 528 monkeypox patients infected in 16 countries identified as gay or bisexual men, according to a study published on July 21 in the New England Journal of Medicine.

As per Kai Kupferschmidt, a correspondent for Science magazine, "homosexual men are criminalized in several nations with outbreaks," he remarked during the lecture. People in those nations "cannot obtain good information to prevent infection and cannot access health care if they become infected." It becomes quite challenging to even recognize the issue in these nations, he said.

Asserting that all nations "engage closely with communities of men who have sex with men, to design and offer effective information and services, and to implement measures that protect the health, human rights, and dignity of impacted people," Ghebreyesus called on all nations to take action. 

Due to the illnes's odd presentation in this outbreak compared to prior outbreaks, doctors may also miss instances of monkeypox. For instance, just 25% of patients in the NEJM research had lesions from monkeypox on their cheeks, and only 10% had the sores on their palms or soles of their feet. 

Instead, lesions were found in the anal and vaginal areas in 73% of individuals and the trunk, arms, or legs in 55% of participants. Additionally, several persons experienced sores in their throats and mouths. The majority of the participants in the study had less than 10 lesions, and 54 of them had just one lesion on their genitalia, making it easy or even likely to mistake them for herpes or syphilis.

In a sample research trial, 70 participants were admitted to the hospital. Of those, 21 were admitted to hospitals due to pain, primarily excruciating rectal pain. Others were unable to drink because of eye lesions, renal damage, heart inflammation, or throat swelling.

These consequences are consistent with what medical professionals have been reporting across the country. The medical director of the New York City Department of Health and Mental Hygiene, Mary Foote, stated July 14 at a news briefing hosted by the Infectious Diseases Society of America, "While death appears to be very low, which is excellent, morbidity has been considerably greater than any of us expected."

"Many patients who have this infection are truly struggling, and some of them could end up with lasting scars and damage. We encounter a lot of folks with symptoms that are so bad that they can't eat, urinate, or use the restroom without experiencing tremendous pain," Foote said.

A few women and kids in the outbreak have also got monkeypox. CDC director Rochelle Walensky stated on July 22 in an interview with the Washington Post that monkeypox had been identified in two youngsters in the United States. She claimed that both of the kids were close friends of males who have sex with men.

Monkeypox was also contracted by a youngster in the Netherlands who had no interaction with known carriers of the virus, according to a study published on July 21 in Eurosurveillance. His situation suggests that monkeypox may be spreading more broadly and covertly than previously thought in communities.

Up to now, monkeypox transmission mechanisms are still a mystery. For example, scientists are unsure if the virus may be spread through semen as a sexually transmitted illness. Researchers have discovered viral DNA in semen, saliva, urine, and feces, although these could simply be dormant virus leftovers. Researchers have not yet discovered any contagious viruses in bodily fluids that could be shared during intercourse in the genitalia. Rimoin added that it is also unknown if contracting the virus through mucosal membranes during sexual intercourse would protect against doing so later.

Rimoin declared that one thing was obvious. People have passed the buck, she said, leaving others to deal with the monkeypox issue. "We're giving this virus an opportunity to run like it never has before," she said, "even if it's everyone's problem to solve today."





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