The local epidemic has been on the rise recently. Monkeypox, a rare infectious disease originally only in Africa, has spread to non-monkeypox-endemic countries in Europe, America and Oceania since May 2022 in the UK. The first case in the UK on May 7 was in a patient who had recently travelled to Nigeria, where he is believed to have contracted the virus and became ill after returning to the UK. In this regard, Raul Rivas Gonzalez, a microbiologist at the University of Salamanca in Spain, in the creative sharing website “The Conversation” (The Conversation), put forward “10 reasons not to worry too much now. “.
1. It is a known virus
Monkeypox was discovered in 1958, when two outbreaks of a smallpox-like disease occurred among monkeys raised in the laboratory. The first human monkeypox case occurred in the Democratic Republic of Congo in August 1970. Since then, scientists have studied the virus and closely monitored monkeypox cases.
2. It is a relatively stable virus
Monkeypox is a relatively large DNA virus that mutates more slowly than coronaviruses, influenza or RNA viruses and has a better system for detecting and repairing mutations, meaning monkeypox is less likely to suddenly or Mutates at high rates, resulting in high rates of human transmission or high variability.
This means that once cured, the patient will have “long-term immunity” to the virus. So far, two genetic clades have been sorted out: the West African clade and the Central African clade. The two are geographically separated and have clear epidemiological and clinical differences. DNA sequences show that the current virus is a mild strain circulating in West Africa, closely related to monkeypox viruses detected in the UK, Singapore and Israel in 2018 and 2019.
3. Some people around the world already have some level of immunity
Monkeypox virus, smallpox virus, and vaccinia virus are all closely related orthopoxviruses. The vaccine, which had previously been successful against smallpox, was declared eradicated in 1980 after people had been vaccinated. Historical data shows that people who have been vaccinated against smallpox have about 85% protection against monkeypox, so people who have been vaccinated against smallpox, which is now a large proportion of people over the age of 45, are less susceptible to the virus.
4. We know how monkeypox is contagious
Human direct contact with blood, body fluids, mucous membranes or skin lesions of infected animals can cause zoonotic infections. Eating raw or undercooked meat from infected animals is also a risk factor. It is also possible for humans to be bitten or scratched by animals.
Human-to-human transmission can occur through close contact with droplets, respiratory secretions, skin lesions, or contact with objects that have been infected with the virus. The virus can also pass through the placenta, from mother to fetus, or through close contact during and after birth, entering the human body through wounds of the skin, respiratory tract or mucous membranes. We understand how the virus spreads, so we can also develop effective preventive measures.
5. Human-to-human transmission is not thought to be too serious
This is the first occurrence of monkeypox in Europe, and there is no epidemiological relationship in West and Central Africa, so the most likely route of transmission is through droplets or contact with infected wounds.
Most cases in Europe are young men, many of whom are homosexual. Close contact between sexual partners increases the chance of infection, but without close contact, the chance of infection is believed to be low.
6. The clinical manifestations of monkeypox are usually mild
Symptoms of monkeypox last 2 to 4 weeks and get better naturally. Historically, African monkeypox has a mortality rate of approximately 0% to 11%, with higher rates among young children.
The West African clade seen in Europe to date has a lethality rate of about 3.6% (according to studies in African countries). Mortality is higher in children, young adults and the immunocompromised, and most recover within a few weeks.
7. Monkeypox symptoms are obvious and unique
The monkeypox virus is easy to trace because, unlike SARS-CoV-2, which can spread asymptomatically, the symptoms of monkeypox are usually not ignored because it causes skin damage. The symptoms of monkeypox (fever, severe headache, swollen lymph nodes, back pain, muscle aches and weakness) also help in the diagnosis of monkeypox and the detection of infected people.
A distinctive rash develops on the skin from the first to the third day of a fever. The rash can appear on the face (95% of cases), palms and soles of the feet (75% of cases). The oral mucosa, genitalia, conjunctiva, and cornea are also affected.
The rash progresses from bulging spots to slightly raised papules, blisters filled with clear fluid, pustules with pale yellow fluid, and finally crusts and falls off. The number may range from a few to several thousand.
8. The detection method of monkeypox is fast and effective
In many laboratories in Europe, America and Africa, monkeypox virus can be detected from potentially infected skin lesions by immediate polymerisation chain reaction. You can use scabs on the infected area, wipe with a swab, and shed fluid for sampling, and you do not need to use blood samples.
Timely PCR nucleic acid detection can not only distinguish monkeypox virus from other orthopox viruses, but also distinguish two different clades.
9. The monkeypox vaccine is very effective
The original (first-generation) smallpox vaccine no longer exists, but new second- and third-generation vaccines have been developed against vaccinia virus. These vaccines showed activity against human smallpox and monkeypox.
ACAM2000 and Sanofi Pasteur’s Smallpox Vaccine (APSV), both based on attenuated, replication-competent viruses, are administered through multiple puncture techniques. The Jynneos vaccine, named Imvanex in the European Union and Imvamune in Canada, is a third-generation vaccine containing a modified Ankara vaccinia virus (MVA-BN), which cannot replicate in the human body, but can induce immunity in the body. Resists smallpox and monkeypox.
The Jynneos vaccine is the only monkeypox and non-replicating smallpox vaccine approved by the U.S. Food and Drug Administration (FDA) for non-military use.
10. Antiviral drugs are very effective
Both Cidofovir and Brincidofovir are active against poxviruses in vitro and in animal studies. Brincidofovir is a potent inhibitor of DNA polymerases against a variety of double-stranded DNA viruses such as monkeypox virus.
Tecovirimat (ST-246) is also effective in the treatment of diseases caused by orthopoxviruses, and human clinical trials have shown that the drug is safe and well tolerated with minimal side effects. Tecovirimat can be used to treat children and adults weighing at least 13 kg, and to treat cowpox, monkeypox and human smallpox.
Despite all this good news, caution and vigilance must be exercised as there are still many unsolved mysteries about monkeypox. While the sudden increase in monkeypox cases may be a mutation that makes the monkeypox virus more likely to spread, the virus may have spread quietly, and each outbreak can be traced back to several simultaneous sources of infection.
Still, it is hoped that the current outbreak can be brought under control without the need for lockdown policies other than vaccination.