Five questions: Answers to key questions about monkeypox and the New Zealand approach
In a Covid-worn world, the global spread of monkeypox – a previously obscure viral disease that rarely traveled beyond central and west Africa – is concerning.
So far, there have been some 200 confirmed or suspected cases of the virus in more than 20 countries, including Australia, Britain and the United States.
Monkeypox does not pose the same risk as the novel coronavirus when it emerged in early 2020. That’s what we know.
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1. Why is monkeypox suddenly so important?
Monkeypox is believed to have originated in rodents in Central and West Africa and has spread to humans several times over the years.
But previous cases outside Africa have been attributed to infected travelers who had visited areas where the virus existed; or these cases were linked to imported animals.
What is happening now is different. The spike in cases outside Africa in recent months means that the virus is being transmitted between people in parts of the world where the disease is not endemic – or not part of daily life.
Cynthia S. Goldsmith, Russell Regner/CDC/AP
This electron microscope image shows oval-shaped mature monkeypox virions, left.
2. What explains the difference in the spread of monkeypox this time around?
It’s not entirely clear.
Johns Hopkins University emerging infectious disease expert Eric Toner sums it up: “Is this unprecedented outbreak due to a change in the virus? Or is it because of a change in behavior? Or is it because of better surveillance, and we just find these cases that we would have missed before? »
“We are working to understand the extent of transmission: are we seeing most of the real cases? Where do we see the tip of the iceberg?
The Guardian reported, for example, that many scientists suspect that low, undetected levels of monkeypox have been circulating in the UK or Europe for several years and may have recently increased in some communities. This is however only a hypothesis.
3. Did something happen to cause this?
There may be more monkeypox than we thought.
A 2010 paper actually suggested that human monkeypox had increased dramatically in the Democratic Republic of Congo (DRC).
Between November 2005 and November 2007, 760 human cases of monkeypox were identified in nine regions of the DRC. This suggests a 20-fold increase in human monkeypox since the 1980s.
In an article by The conversation this week, Oyewale Tomori, a fellow of the Nigerian Academy of Sciences, said it was likely that many cases of monkeypox in the country had been missed over the years.
CDC via AP
This image from 1997 shows a patient whose skin showed a number of lesions caused by the virus.
4. Is there anything to worry about?
Vaccines against smallpox, which was eradicated in 1980, also work against monkeypox.
The reason there is a problem here is that routine vaccination against smallpox stopped soon after the eradication of this virus. Young people no longer have immunity.
The good news, as Toner of Johns Hopkins University explains, is that the symptoms of monkeypox are similar to but less severe than those of its “cousin” smallpox, causing mostly relatively mild illness.
Monkeypox also spreads much less efficiently than Covid-19, for example. You may see the symptoms of monkeypox. It’s a bit more difficult with Covid.
Monkeypox and smallpox viruses also mutate much more slowly than Covid and influenza viruses. Good news too.
CDC via AP
The hands of a monkeypox patient in the Democratic Republic of Congo.
5. How is New Zealand addressing monkeypox?
The government is not too alarmed.
Covid-19 Response Minister Chris Hipkins said cases were likely here and the country was prepared. Contact tracing was important and easier than with Covid.
A spokesman for the Ministry of Health, however, said that the stocks of smallpox vaccine used until 1980 in that country were not suitable for the prevention of monkeypox.
Options for obtaining smallpox vaccines and antiviral drugs for use against monkeypox are being explored.
“If there was a case in New Zealand, an appropriate strategy would be a targeted strategy. This may include close contact with the patient and the health workers who are on the front line to care for a case. »