While monkeypox isn’t likely to become a pandemic, its rapid spread worldwide has caught some public health officials by surprise. And the World Health Organization’s leading expert on the virus wonders if ending a worldwide effort to vaccinate against smallpox cleared the way for monkeypox to spread.
That came up during a public briefing by WHO’s Dr. Rosamund Lewis on Monday on the hundreds of cases of monkeypox now seen in dozens of countries, according to The Associated Press. WHO reported Saturday that since May 13, 23 countries where monkeypox is not endemic have reported cases of the virus.
“The vast majority of reported cases so far have no established travel links to an endemic area and have presented through primary care of sexual health services,” the organization said.
WHO called the identification of confirmed and suspected cases that do not have direct travel links to endemic areas like western and central Africa “atypical.”
“Monkeypox is related to smallpox, but has milder symptoms,” the AP reported. “After smallpox was declared eradicated in 1980, countries suspended their mass immunization programs, a move that some experts believe may be helping monkeypox spread now, since there is now little widespread immunity to related diseases. Smallpox vaccines are also protective against monkeypox.”
Whether people who did previously have a vaccine against smallpox are still protected — or to what extent — is not known, Lewis said. Routine vaccination took place decades ago.
Lewis said quick action is needed to keep monkeypox from becoming established worldwide the way smallpox was in the past.
Symptoms of monkeypox include exhaustion, fever, chills, muscle aches, nausea and headaches, among others. Then a rash develops, often turning into pus-filled lesions before scabbing over and falling off. Usually, the illness resolves itself, though deaths have been reported.
A sexual link?
Most of the reported monkeypox cases have been among men who have sex with men, though the World Health Organization has emphasized that the issue is close physical contact with someone who is infected, rather than sexual transmission. They say anyone who had close contact with someone who has monkeypox could be infected. Close contact includes coming in contact with linens or clothing used by someone with monkeypox lesions.
The Daily Mail said health officials believe the virus’ spread was aided by sexual contact among some people attending raves in Spain and Belgium, though that certainly was not true for all the cases. In Congo and Nigeria, where cases are much more common, people are most apt to be infected through contact with animals, including primates and wild rodents.
Lewis reported that many of the current cases include lesions in the genital area, where they are not noticeable. “You may have these lesions for two to four weeks (and) they may not be visible to others, but you may still be infectious,” she said.
Global spread
Cases so far have been confirmed in Australia, Austria, Belgium, Canada, Czechia, Denmark, Finland, France, Germany, Israel, Italy, Netherlands, Portugal, Slovenia, Spain, Sweden, Switzerland, the United Arab Emirates, the United Kingdom and the United States, according to the international health agency.
Suspected cases are also being investigated in Argentina, French Guiana and Sudan.
And there are, of course, also cases seen in countries where monkeypox is endemic, including Cameroon, Central African Republic, Democratic Republic of Congo, Nigeria and the Republic of the Congo, the World Health Organization reported.