Global Race to Track and Contain Monkeypox Outbreak

Sudden emergence of monkeypox cases in several countries spanning multiple continents has raised questions about how the virus, common in west and central Africa, managed to spread. Facing these surprise transmissions, the Belgian government issued mandatory 21-day isolation for monkeypox cases, and the UK Health Security Agency has also updated its guidance advising close contacts to isolate for 21 days.

First discovered in 1958, the monkeypox virus (MPV or MPXV) belongs to the Orthopoxvirus genus, it is a double-stranded DNA zoonotic virus that causes monkeypox in humans and animals, the usual symptoms are rash and fever. The Orthopoxvirus genus also includes variola virus (smallpox), vaccinia virus (used in the smallpox vaccine), and cowpox virus.

Infections usually occur outside of west and central parts of Africa when a person becomes infected locally and then returns home, bringing the virus with them; these cases normally do not cause larger outbreaks. However, this new wave of infections predominantly with no link to travel or animals across Europe, North America, and Australia has prompted the World Health Organization (WHO) to expand surveillance to non-endemic regions and expects more cases to be identified.

Monkeypox endemic countries are: Benin, Cameroon, the Central African Republic, the Democratic Republic of the Congo, Gabon, Ghana (animals only), Ivory Coast, Liberia, Nigeria, the Republic of the Congo, Sierra Leone, and South Sudan.

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Cases Have Been Rising, but Low Risk to Population 

Despite being the largest outbreak outside of Africa in the past five decades, monkeypox does not spread easily between people. The WHO and health bodies such as the US CDC say that the threat to the general public is low and not comparable to the COVID-19 pandemic.

According to the CDC, human-to-human transmission mainly occurs via large respiratory droplets. “Respiratory droplets generally cannot travel more than a few feet, so prolonged face-to-face contact is required,” the CDC says. Other transmission means include direct contact with bodily fluids or indirect contact with lesion material-contaminated clothing. WHO shared that recent infections appear to have been spread through sex.

Vaccines are now offered to high-risk healthcare providers but are not widely available yet. Recently, Bavarian Nordic A/S announced that it is ramping up Jynneos (Imvanex in Europe; Imvamune in Canada) production following the outbreak. Studies showed that the Jynneos smallpox vaccine is about 85% effective in preventing monkeypox, while immunization after monkeypox exposure may also prevent the disease or reduce its severity.

Author

Fujie Tham