Why Everybody Worries About Monkeypox?

monkeypox

Last Updated on 24 October 2022

Since its first appearance, in the past May, the monkeypox outbreak raised large concerns around the world, especially in Europe, where it has broken out with particular virulence. Why?

We had not overcome the pandemic yet, when the early news about the monkeypox outbreak announced the arrival of a new menace.

It immediately appeared clear that monkeypox was and is not deadly or severe, and, hence, why governments, healthcare authorities and organizations are so worried about this umpteenth infectious disease?

Is there anything we don’t know about monkeypox? We are going to face another pandemic? In short, the epidemic of monkeypox is still shrouded in mystery.

This post was born just to cast a light on this mystery.

Let’s start!

Monkeypox Overview

Monkeypox is an infectious disease caused by a close cousin of Smallpox virus. While the latter is deadly and transmitted from human to human, monkeypox virus is known as a natural pathogen of animals, such as monkeys and rodents, and for being a virus which causes mild symptoms among humans.

For this feature, monkeypox is considered a zoonotic disease, namely a disease transmitted from animals.

monkeypox disease

Both Monkeypox and Smallpox viruses belong to the genre of Orthopoxvirus, a type of pathogens included in the family of Poxviridae, a large group of oval shaped viruses, with double helix DNA. Also called poxviruses, these pathogens are able to cause skin lesions to infected patients.

Many mistake monkeypox virus with chickenpox or varicella virus, but the latter does not belong to poxviruses, but to the one of varicella zoster.

Moreover, monkeypox skin lesions are larger than the ones from varicella.

After an incubation time from 2 to 17 days, monkeypox gives rise to malaise, headache, fever, lymphadenopathy (absent in Smallpox) and deep, disseminate skin lesions, which, in the final stage of the disease, evolve from vesicles, to pustules and crusts. The disease lasts from two to four weeks, overall, and can be prevented thanks to vaccines.

This matter is another source of concern for many individuals.

Concerns About Monkeypox Vaccine

The genetic similarity between Monkeypox and Smallpox viruses makes smallpox vaccine suitable to prevent monkeypox, as well. Smallpox vaccine, indeed, has a protection of 85% against monkeypox.

However, like most vaccines against infectious diseases, protection drops over time. The current monkeypox vaccine is named JYNNEOS and must be administered through two doses (in a lapse of 14 days from each other). Unfortunately, after these two doses, the duration of immunity is currently unknown.

This detail might be another reason for the wide concerns linked to monkeypox. In short: monkeypox is not lethal, in most of the cases; we also have vaccines, but global health authorities consider it as a severe menace for everybody.

The list of concerns about this infectious disease is very long and continues in the following paragraphs.

Concerns About Monkeypox Spreading

Traditionally, monkeypox is endemic in the regions of Africa. The first outbreak occurred in 1970, in Congo. The epidemic was likely caused by a strict contact among humans and animals.

Other cases have been reported over the years around the world: the first case of monkeypox out of Africa occurred in 2003, in the United States, and was due to a close contact with infected prairie dogs.

The oddity occurred in May 2022, when several cases of monkeypox have been identified among humans in Europe, especially after the gay pride in Spain.  It seems this event has been the trigger which spread the contagion. Afterwards, monkeypox cases occurred across Europe and the world.

Indeed, in July 2022, a shocking study published on The Lancet revealed information about demographic and clinical characteristics of confirmed human monkeypox cases in individuals attending a sexual health center in London.

These individuals were all men and these infected men were homosexual. At the time of the study, the confirmed cases were 54, those who got monkeypox were men who have sex with men, and the contagion didn’t relate to men who travelled to Africa.

Moreover, in the European areas, monkeypox is not endemic. What happened, hence?

The same types of cases have been confirmed in other countries and created a new stigma against homosexual men, defined as MSM (Men Sex Men).

Many people affirmed that Monkeypox is like HIV virus, but if this statement was true, we could think monkeypox will end up to infect heterosexual individuals, also.

Concerns About Monkeypox Data in Europe and the World

The European Center for Disease Prevention and Control shows the following data updated on September 13, 2022 about the situation of Monkeypox in Europe: 19 379 confirmed cases of monkeypox (MPX) have been reported in 29 European countries.

47 additional cases have been reported in three Western Balkan countries and Turkey.

Most cases are in these five European Countries: Spain (6 947), France (3 784), Germany (3 547), Netherlands (1 192) and Italy (813) (the data are constantly updated, and, when you read this article, they could be different).

The European Center also reveals that “cases of MPX continue to be reported primarily among men who have sex with men (MSM) aged between 18–50 years”. 

Conversely, the global map of the current monkeypox outbreak, updated on September 19, 2022, reported 62,406 confirmed cases, but the strange data is that 61,827 cases are in places where the disease has historically never been reported, namely: 265 cases in Argentina, 132 in Australia, 300 in Austria, 744 in Belgium, 6,649 in Brazil, 1363 in Canada, 23,892 in the United States,3,552 in the United Kingdom, and only 2 cases in Russia (where homosexuality is hard to practice).

The data table is fairly large as you can see online. What is strange is the spread of the contagion: men who have sex with men, who didn’t come from endemic countries and who never have had close contacts with animals.

Concerns About Monkeypox Transmission

The current monkeypox outbreak is, in fact, characterized only by sexual transmission among humans. The few women affected were heterosexual and identified as infected by sexual transmission. Currently, the overall ratio of infected women is two per 100 men.

What these data tell? They inform us about why everybody is worried about monkeypox.

Indeed, what raises concerns around the world is that the disease spreads by sexual transmission, especially men with men, along with a small group of women who have sex with bisexual men.

These new features push scientists to think that monkeypox is no longer a zoonotic disease. It does not spread from animals to humans, only.

And, above all, it does not spread by skin contact, contaminated surfaces or droplets, only.

The identified individuals in the aforementioned studies have reported a contagion only by sexual transmission.

That is why the current monkeypox outbreak is rousing concerns all over the world. According to the World Health Organization, there isn’t comprehensive information relating to the history of monkeypox, its natural reservoirs, and how the virus evolves and circulates in our environment.

Concerns About Monkeypox Fatality Rate

A confirmed detail regards the fatality rate of monkeypox: it is very low, around 3%. Cases of neurological damages and encephalopathy have been reported from immunocompromised HIV patients with a concurrent monkeypox infection.

Usually, indeed, the few monkeypox deaths reported from the current data relate to patients immunocompromised by previous diseases or with poor health conditions.

Healthy people, instead, get fully recovered from monkeypox. But these optimistic data are not enough to appease the international concerns about the disease.

What remains extremely weird is the main reason for all this fear. Why is monkeypox so very fearsome for many? Where is the epicenter of this fear? It depends on the features of the virus, by the transmission way, by the rapidity of the contagion around the globe? Or on What else?

The questions are really many in this case. An Italian virologist interviewed by an Italian newspaper tried to give his own answers and point of view.

Concerns About Monkeypox: What an Italian Virologist Said

For Who and UE, monkeypox poses a threat and an emergency, due to the unprecedented and unpredictable spread of the virus.

That was a forgotten virus, but a few clinical features and new symptoms force us to study this neglected pathogen. 

These are the words of Dr. Marco Clementi, full professor and director of the Microbiology and Virology Laboratory Vita-Salute at the San Raffaele University in Milan.

The epidemic of this year has been extremely unusual. According to the Italian scientist, neurological complications in affected patients, such as encephalitis, convulsions, and even myocarditis are quite strange with this type of infection.

All this makes us think that monkeypox virus might be changed, but the Italian doctor is not convinced about this aspect.

Interhuman transmission is the true news in this novel outbreak; the virus is always the same. To be sure of the mutation, we should have a different sequence.

Maybe, poorly treated HIV patients have experienced a more severe infection, but we need further studies about this subject.

We must study the interhuman transmission of this virus, because it is this unusual feature which rouses true concerns among the scientific community.

The words of the Italian doctor have likely unveiled the main reason for the global concerns about monkeypox, namely an atypical contagion, but there could be another reason behind the new outbreak of monkeypox.

Monkeypox and Climate Change

Scientists agree on a shared point: climate change and global warming are changing the map of the spread of viruses and related diseases.

Viruses are able to mutate over and over again and to recombinase with other similar viruses, giving rise to strange and deadly illnesses.

Animals are leaving their natural habitat and a few of them may be new reservoirs of viruses like monkeypox.

Sars Cov2 was a novel virus, but if viruses, like monkeypox or smallpox, resume infecting humans with strange or severe symptoms or with different transmission ways due to climate change or impaired condition of our immune system, this will be a serious concern for everybody.

However, the mystery remains unsolved: climate change should give rise to disease affecting all humans as a whole. Monkeypox, instead, affects homosexual men, the most!

Conclusion

Unfortunately, the matter is still anecdotic and unclear. Of course, we must be ready to face a virus which regained vigor after a long time of latency.

Unless the zero-patient had sex with King Kong, there is no further plausible explanation about the concerns raised by a neglected zoonotic virus which learned to infect humans by sexual transmission, turning out, as a matter of fact, into a sexually transmitted disease (STD).

Monkeypox spreads among humans, above all homosexuals, at this moment. No previous contact with animals confirmed, only homosexual sex.

Nobody has faced this issue with the proper interest and vigor, so far.

Scientists talk about the need for more studies, but it seems that someone wants to hide the true cause of the current outbreaks of monkeypox.

Every day there are tons of migrations from Africa to Europe. No surprise if monkeypox had come from a sexual intercourse between a monkeypox positive African and a European gay man.

Climate change or no, it would be better if someone considered monkeypox seriously; otherwise, unaware individuals could think this disease is a wicked manipulation to sell vaccines.

I think monkeypox is a serious matter, and if you have a further opinion about it, your comment will be welcomed.

References & Bibliography:

  1. Monkeypox – World Health Organization – Newsroom – www.who.int/news-room/fact-sheets/detail/monkeypox
  2. Infezioni da Poxvirus – Humanitas – www.humanitas.it/enciclopedia/infezioni/infezione-da-poxvirus/
  3. Andrea M. McCollum – Travel-Related Infectious Diseases -Smallpox & Other Orthopoxvirus-Associated Infections – Centers for Disease Control and Prevention – Chapter4 – wwwnc.cdc.gov/travel/yellowbook/2020/travel-related-infectious-diseases/smallpox-and-other-orthopoxvirus-associated-infections
  4. Jynneos Vaccine -Centers for Disease Control and Prevention – www.cdc.gov/poxvirus/monkeypox/interim-considerations/jynneos-vaccine.html#duration
  5. Nicolò Girometti, MD Ruth Byrne, MBBS, Margherita Bracchi, MD,Joseph Heskin, MBChB, Alan McOwan, MRCP, Victoria Tittle, MBBS, Keerti Gedela, FRCP, Christopher Scott, FRCP, Sheel Patel, FRCP, Jesal Gohil, MBChB, Diarmuid Nugent, MBBChir, Tara Suchak, MBChB, Molly Dickinson, MBChB, Margaret Feeney, MSc, Borja Mora-Peris, PhD, Katrina Stegmann, MBBS, Komal Plaha, MBBS, Gary Davies, MD, Luke S P Moore, PhD, Nabeela Mughal, FRCPath, David Asboe, FRCP, Marta Boffito, PhD,Rachael Jones, MBBS, Gary Whitlock, PhD – Demographic and clinical characteristics of confirmed human monkeypox virus cases in individuals attending a sexual health centre in London, UK: an observational analysis – The Lancet – July 01, 2022 –  www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00411-X/fulltext
  6. Monkeypox situation update – European Centre for Disease Prevention and Control –www.ecdc.europa.eu/en/news-events/monkeypox-situation-update
  7. 2022 Monkeypox Outbreak Global Map – Centers for Disease Control and Prevention –www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html
  8. Paho-Who – Epidemiological Update: Monkeypox in women – 26 August 2022 – Reliefweb-https://reliefweb.int/report/argentina/epidemiological-update-monkeypox-women-26-august-2022
  9. Giovanna Trinchella –  Monkeypox, il virologo Clementi: “Era un virus dimenticato. Studiare e capire la vera novità: la trasmissione interumana”.- Il Fatto Quotidiano-  September 17, 2022 – www.ilfattoquotidiano.it/2022/09/17/monkeypox-il-virologo-clementi-era-un-virus-dimenticato-studiare-e-capire-la-vera-novita-la-trasmissione-interumana/6803365/
  10. Dr. Marco Clementi, full professor and director of the Microbiology and Virology Laboratory at the San Raffaele University in Milan.
  11. James Wilson – Climate change is likely behind the global outbreak of monkeypox, a professor of health systems has said – Newstalk- 29 May 2022-www.newstalk.com/news/climate-change-to-blame-for-monkeypox-outbreak-says-professor-1348966
Author: Rosalba Mancuso
Rosalba Mancuso is a medical journalist, an international content writer credited at the University of Washington and a blogger born in Sicily. She is popular for founding four websites in English. On Modernhealthinfo.com, Rosalba writes well researched and detailed health articles backed by her experience as a medical writer for pharma companies and as a PR assistant for a clinical analysis laboratory. She is also a member of the AHCJ, American Association of Health Care Journalists and Center for Excellence in Health Journalism.

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