Mint Explainer: Can lessons from Covid help fight monkeypox?

“At the moment, this is an epidemic that is concentrated among men who have sex with men, especially those who have multiple sexual partners,” said WHO Director-General Tedros Adhanom Ghebreyesus. , on July 23, while declaring it a public health emergency. But the US has also reported cases in children, raising fears it could spread beyond gays and bisexuals There is now an approved vaccine in the US and Europe, but demand is expected to soar well beyond supply, as has already been seen in the United States. about social distancing and masks again. India has also reported a few cases and cannot be complacent.

With all the lessons it has learned from the Covid crisis, can the world stop monkeypox from snowballing?

What is monkey pox?

It is a disease spread by the monkeypox virus. The name monkeypox comes from its earliest origins. It was first discovered in 1958 among a cohort of laboratory monkeys intended for research. The first human case appeared more than a decade later, in 1972. Monkeypox is a viral zoonotic infection and can spread from animals to humans.

Monkeypox virus belongs to the same family of viruses that causes smallpox. This is the reason why smallpox vaccines are also effective in controlling monkeypox. However, the symptoms of monkeypox, although similar to those of smallpox, are milder and rarely cause death. Monkeypox has no connection to chicken pox as some mistakenly believe.

Prior to this year’s outbreak, cases of monkeypox continued to surface in Central and West African countries. The spread of cases beyond Africa earlier was largely a consequence of international travel to and from countries where this virus was endemic.

Already this year, cases have been more than 16,000 in 75 countries, forcing the WHO to label it a “public health emergency of international concern” (USPPI). Under the International Health Regulations 2005, countries are legally required to be aware of a PHEIC and this often results in a concerted global movement against a disease, with pooling of financial and medical resources. This is the seventh declaration PHEIC by WHO since 2009 after H1N1 (2009), poliomyelitis (2014), Zika (2015), Ebola (twice, 2013 and 2018) and Covid-19.

How is monkeypox spread? What are the symptoms?

Common symptoms of monkeypox are fever, headache, muscle aches, back pain, fatigue, and swollen lymph nodes. This is accompanied by a rash on certain parts of the body such as the face, eyes, mouth, throat, groin, and genital and anal regions. Symptoms usually persist for two to three weeks and gradually resolve on their own, although some medication may be needed for fever or pain. People remain contagious until all painful lesions disappear and are replaced by a new layer of skin.

According to the WHO, monkeypox is spread through close contact, including face-to-face, skin-to-skin, mouth-to-mouth, mouth-to-skin and sexual contact. An infected person can also contaminate just about anything in their environment with the monkeypox virus, from surfaces and objects to clothing and electronic equipment. The virus can spread through respiratory droplets and short-range aerosols, although scientists are still trying to figure out how it spreads through the air.

An overwhelming number of infections (90% and more) have been transmitted through sexual contact, a New England Journal of Medicine study reveals – around 98% of infected people covered in this study were gay or bisexual men. But experts have warned against stigmatizing a certain part of the population. Here is what the WHO says: “The virus is not only spread through sexual contact, but also through any form of close contact with an infectious person. People living in the same household are more at risk. Anyone with symptoms that may be monkeypox should seek advice from a healthcare worker immediately. The virus can also spread from mother to fetus during pregnancy, or from a parent with monkeypox to an infant or child through close contact.

The WHO says pieces of monkeypox virus DNA have been found in semen, but it is not yet known whether the infection can be spread through semen, vaginal secretions, amniotic fluids, breast milk or blood. According to the WHO, those most at risk of serious illness or complications are pregnant women, children or immunocompromised people.

Monkeypox can spread to people when they come into physical contact with an infected animal, as seen in West and Central Africa. Animal hosts have been mainly rodents and primates.

How effective are vaccines?

New, safe smallpox vaccines have also been shown to be effective against monkeypox. In fact, one has been specifically approved for monkeypox – Jynneos in the USA, made by Bavarian Nordic. The EU also approved the vaccine on Monday, marketed as Imvanex. But meeting the growing demand for vaccines will be a daunting challenge. Already, there are long lines outside clinics in the United States amid large shortages of two-dose Jynneos.

Vaccination against smallpox stopped worldwide in 1979 after the eradication of the disease. Vaccine production has also been reduced. It is unclear whether India has the capacity to mass manufacture smallpox vaccines in large numbers if needed.

For now, not everyone can get vaccinated. According to the WHO, only people at risk (for example, someone who has been in close contact with someone with monkeypox) should be vaccinated. He does not recommend mass vaccination.

The United States Food and Drug Administration (FDA) has issued a vaccine warning. In the United States, with Jynneos, another vaccine – ACAM2000 – is available but can have serious side effects. ACAM2000 can cause myocarditis and pericarditis, according to the USFDA. In addition, persons recently vaccinated with ACAM000 can also infect unvaccinated persons with the vaccine virus through close contact. The Jynneos vaccine may also have side effects such as muscle aches, headaches, fatigue, nausea and chills.

Singapore has warned of the benefits of the vaccine. The Singapore Ministry of Health (MOH) does not recommend mass vaccination against monkeypox. Health Minister Ong Ye Kung said Monday, “At this time, given the self-limiting nature of the disease, the Ministry of Health does not recommend mass vaccination of the entire population against monkeypox. , as the benefits do not outweigh the risks”.

How can you avoid getting infected?

The approach to preventing a monkeypox infection is in some ways similar to the fight against Covid. As it spreads through close contact between people, social distancing and wearing masks in public places are already advised by many experts. A surgical mask will work although obviously an N95 is the safest. The risk of contracting monkeypox from animals can be reduced by avoiding unprotected contact with wild animals, especially those that are sick or dead (including their meat and blood). As another precaution, any food containing meat or animal parts should be thoroughly cooked before consumption. Thermal scanners can also help monitor people in public places for early symptoms of illness.

India has issued detailed guidelines to prevent the spread of monkeypox. People with symptoms such as fever and rash, in an area where monkeypox has been reported, should seek immediate medical attention from the nearest health facility.

The Kerala government has also issued detailed SOPs. Anyone with fever and red spots at international airports will be transferred to the nearest hospital with isolation facilities. Doctors must wear PPE kits while patients must wear N95 masks. Also, international travelers have been advised against eating or preparing wild game meat (bushmeat) or using products (creams, lotions, powders, etc.) derived from wild African animals.

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