By Jenny Manrique
Although the monkeypox virus does not spread as widely and rapidly as COVID-19, medical experts stress that the only way to avoid a new epidemic is through an early response from health authorities and the public. Key steps are getting tested, vaccinated and sharing information through public health campaigns.
According to the Centers for Disease Control and Prevention (CDC), more than 4,000 cases of monkeypox have been detected in 44 countries around the world, including 200 in 25 states in the U.S. California, New York, Florida, and Illinois are the most affected. No one has died of monkeypox in the country, according to the CDC, but in Africa, the virus has claimed the lives of 73 people.
The virus’ most recognizable symptom is a rash that can look like pimples or blisters that appear on the face, inside the mouth, appendages, and the genital area. Other symptoms include fever, headache, muscle aches and backaches, and swollen lymph nodes.
“98% of the cases have occurred in men and that’s a striking epidemiologic feature,” said Dr. William Schaffner, Professor of Medicine in the Division of Infectious Diseases at the Vanderbilt University School of Medicine, during a media briefing (Watch complete coverage) hosted by Ethnic Media Services on June 24th.
The virus was spread initially among gay and bisexual men at gay pride events in Europe, particularly in the Canary Islands, Berlin, and France. “At the moment it is a viral infection rather confined to a distinctive group of people (who) should be very careful about their current sexual practices, avoiding anonymous sex, and being personally clean, inspecting themselves and their partners to see whether they have lesions,” said Schaffner.
“This is a virus which is spread through close personal contact, usually skin to skin contact among humans”, explained Shaffner. “It can be spread via droplet transmission, if people are very close within three feet, usually over a long period of time, or through contaminated towels and perhaps bedding or sex toys… The incubation period could take up to two weeks.”
Even though it found an epidemiological opportunity to spread among men who have sex with men, “monkeypox is not a gay disease,” stressed Dr. Gregg Gonsalves, Associate Professor of Epidemiology at the Yale Institute for Global Health and Co-Director of the Global Health Justice Partnership.
Gonsalves, an expert on gay men’s health, warned that “stigmatization and discrimination” will make it harder to confine and contain the virus. “If you clamp down on LGBTQ Pride parades across the world over the next few months or use police or other law enforcement, you’re likely to drive people away from care and away from public health officials who don’t want to let it spread.”
The new CDC guidance on monkeypox, includes key information on symptoms, vaccines, prevention, contact tracing, and resources for health care providers and the general public as well.
“In the US context many of the people who are in charge of our public health institutions right now are old HIV doctors… so there’s been ongoing communication between the LGBT and HIV community and the federal and state governments, unlike what we saw 40 years ago with AIDS in the very beginning,” said Gonsalvez.
From Wild Animals
The monkeypox is a member of the larger family of orthopox viruses, which include the mousepox, the camelpox, the cowpox, and the smallpox already eradicated from the face of the earth, explained Ben Neuman, Professor of Biology and Chief Virologist of the Global Health Research Complex at Texas A&M.
It was first identified in primate species in Nigeria, West Africa, a strain that produces milder infections in comparison with a second major strain detected in Central Africa, which is more severe. “The virus has been associated with two kinds of wild animals: the Congo rope squirrel, and the Gambian giant pouched rat,” Neuman added. “As with other viruses that come from rodents, you tend to see increases when there has been a particularly rainy year.”
Given its characteristics of transmission, Neuman warned that monkeypox “could spread easily inside a crowded dance club or at a concert or any other venue where you have lots of people together and they’re having a good time… It’s not something that is scary right now, but could get out of hand.”
Other places where there is close physical contact are homeless shelters, refugee camps, gyms and health clubs.
The only thing that is keeping that virus from getting out to the rest of the world, Neuman argued, is the “relative geographic and economic isolation of the area.. I do not believe that we can count on that as an effective stop gap in the future.”
The virus has been growing in places with less access to testing and fewer hospitals that can actually confirm the numbers, which are almost certainly underreported. The recommendation from experts is to get tested through a PCR, a similar test to the one used to diagnose COVID. The CDC is working on expanding the number of locations where testing can take place.
There is also a vaccine available for the prevention of monkeypox in people ages 18 and older – the Jynneos vaccine – approved in 2019 by the Food and Drug Administration (FDA). It requires two doses, four weeks apart, but doctors noted that the supply worldwide is not robust. The medication tecovirimat (TPOXX) has also proven to have some effect in protecting people.
“Infectious diseases are always going to be with us but epidemics are a human creation, which means we can stop them,”
Dr. Gregg Gonsalves, Global Health Justice Partnership
“(In the US) we spend 3 cents on every health care dollar on public health. It’s a people problem and an infrastructure problem. Hopefully with COVID, monkeypox, HIV we would learn the lesson of making a real investment and avoiding this blooming cycle,” he concluded.