Should we be afraid of monkey pox?

Should we be afraid of monkey pox?

The notion that we will have to live with COVID as a new human pathogen may be deepening in the general population. If you want an update, check out Mark Crislip’s new post (it’s great that Mark is back SBM – his dry humor was lacking). For a long time, I resigned myself to the idea that we would basically never return to normal before COVID. Routine masks are probably the new standard in healthcare. Once a new infectious measure is added during my career, it will never go away.

It is possible that humanity will also have to get used to the idea of ​​not only living with COVID, but living in a world in which pandemics are taking place more and more often. I don’t think another century will pass until the next COVID, and things are much worse than COVID, which is on the fringes of civilization and waiting for its chance. COVID should be a wake-up call and, in an even more semi-national world, would lead to a much stronger international effort to reduce zoonoses (animal-to-human infections), respond quickly to new outbreaks and vaccinate everyone.

Speaking of which, you may have seen reports of a new virus, monkeypox, being reported in various parts of the world. The World Health Organization (WHO) recently reported 250 confirmed cases in 16 different countries. It includes (as of May 23) 20 confirmed cases in the United Kingdom, one confirmed and four suspected cases in the US. Before COVID, an outbreak like this would hardly register. Now, of course, epidemics are causing people to twitch a little. I remember that in February 2020, “voices of reason” said about COVID (including me) that we should worry, but it is too early to panic. I don’t know if it hit the right tone backwards (without Monday morning’s Thursday), but I have a feeling we’re in the same place with monkey pox now.

Any new outbreak of zoonosis should be taken seriously and is a cause for concern, but we cannot panic every time it happens. It would help if we could all count on those responsible to respond appropriately and tell us if we need to take any action. The WHO does not currently recommend any locking or special measures. They characterize these foci as “sustainable”. That’s reassuring, but let’s take a look at chickenpox to give us a better idea of ​​how we should worry.

Smallpox is not new, it is a well-known virus closely related to smallpox. Smallpox was the scourge of humanity declared out of the world in 1980 due to a massive vaccination campaign. Monkeypox is a virus, a member of the group orthopoxvirus family in the family Poxviridae – the same genus as smallpox. As the name suggests, it is zoonotic, transmitted from animals to humans. It is less contagious than smallpox and causes less serious illness, typically rash, fever and inflamed lymph nodes lasting 2-4 weeks. Mortality depends on the strain and ranges from 0-10%, with the WHO reporting an average of 3-6%. Although it may be relatively low, it is still worrying, especially if one of the more virulent strains breaks out.

Smallpox was first identified in the Congo in 1970 and most outbreaks since then have been in Africa. This is why recent epidemics have aroused the interest of experts, as they are spreading beyond their usual scope. Another cause for concern is that, as we have all learned from COVID monitoring, reports of confirmed cases are likely to be several weeks behind. So by the time we know of outbreaks in other countries, the virus has probably spread even further.

There is good and bad news about the vaccine. The good news is that the smallpox vaccine transmits about 85% of monkeypox coverage. So we already have effective vaccines and many people are vaccinated. The bad news, however, is that if you are under 45, you probably won’t be vaccinated because smallpox has been eradicated. But another piece of good news, Moderna (one of the mRNA companies) is already working on a specific smallpox vaccine.

Monkey pox is spread mostly by direct physical contact with body fluids, but also by contact with contaminated surfaces and droplets. A 2013 study also found that aerosolized smallpox can remain infectious for up to 90 hours, but this may not be a significant mode of transmission. Thus, camouflage, avoidance of physical contact, surface cleaning and social distancing seem to be highly effective, and this is partly why the WHO believes that recent outbreaks can be suppressed. This can also be combined with contact tracing.

Given all this, should we be afraid of smallpox monkeys? Yes and no. Currently, outbreaks are limited and restrictions are possible. We have methods for the prevention and treatment of smallpox. This is exactly the scenario for which we need a robust international rapid response capability to suppress these outbreaks in their infancy before they become epidemics or pandemics. But we must constantly monitor the situation, because we also know how quickly they can get out of control. Epidemics like this have always taken place in the background, while the general public usually does not know about them or pays little attention to them. The main difference now is that we are careful.

I also firmly believe that COVID should have taught us that we need to radically change the vaccine conversation, and that smallpox can be a strong reminder if we need to. Vaccines are our best defense against a world in which viruses and other agents are constantly evolving to exploit a large human population who travel frequently around the world. The world is basically a petri dish for infections, and we have also become more vulnerable by adapting too much to wildlife populations. We need the protection that only vaccines can provide.

Tolerance against lies and propaganda against vaccination must be a thing of the past. We must aggressively marginalize and face anti-vaccination views. This must also be associated with much higher vaccine requirements. Although I do not agree with forced vaccination (which is probably not feasible at all), it is quite reasonable (given the fact I have outlined above) to make it very difficult to live in this world as someone who refuses to do their common things. a sense of duty to protect oneself and others by vaccination. It’s your choice, but now you have to stay away from everyone else (metaphorically speaking). It is clear that such regulations must be at the federal level (and when it comes to international travel) – universality is at stake.

Either that, or we have to accept the fact that we live in a pandemic world.

  • Founder and currently executive editor of Science-Based Medicine Steven Novella, MD is an academic clinical neurologist at Yale University School of Medicine. He also hosts and produces the popular weekly scientific podcast The Skeptics’ Guide to the Universe and authors NeuroLogicaBlog, a daily blog that covers news and issues in neuroscience, but also general science, scientific skepticism and philosophy science, critical thinking and media intersection and companies. Dr. Novella also prepared two courses with The Great Courses, and published a book on critical thinking – also called Skeptic’s guide to space.

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