1000 cases of monkeypox in 29 countries: Who is at risk?

1000 cases of monkeypox in 29 countries: Who is at risk?

The World Health Organisation on Wednesday said that more than a thousand cases of monkeypox infection have been confirmed from as many as 29 countries around the globe.

“The risk of monkeypox becoming established in non-endemic countries is real," WHO director-general Tedros Adhanom Ghebreyesus said in a press conference.

The zoonotic disease (infectious diseases spread between animals and people) is endemic in humans in nine African countries but cases have been reported in the past month in several other states — mostly in Europe, and notably in Britain, Spain and Portugal.

What is monkeypox?

Monkeypox is a rare disease caused by monkeypox virus, which belongs to the same Orthopoxvirus genus that also includes smallpox-causing variola virus.

Monkeypox is a zoonosis, a disease that is transmitted from infected animals to humans.

Monkeypox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research, hence the name ‘monkeypox’, according to the US Centers for Disease Control and Prevention (CDC).

The WHO says that cases occur close to tropical rainforests inhabited by animals that carry the virus.

Must read: 'Entirely new spread of monkeypox': Infectious disease specialist on who is affected, what happens next

The infection has been detected in squirrels, Gambian pouched rats, dormice, and some species of monkeys.

It spreads by a bite or direct contact with an infected animal's or person’s blood, meat or bodily fluids, and initial symptoms include a high fever before quickly developing into a rash.

People infected with it also get a chickenpox-like rash on their hands and face.

Symptoms of monkeypox are fever, headache, muscle ache, back ache, fatigue, swollen lymph nodes, skin rashes or lesions.

Who is at risk?

WHO chief said that cases have been reported mainly, “but not only, among men who have sex with men".
“Some countries are now beginning to report cases of apparent community transmission, including some cases in women," he said.

Tedros said he was particularly concerned about the risk the virus poses to vulnerable groups, including pregnant women, children and people with weakened immunity due to other health conditions.

Human-to-human transmission can result from close contact with respiratory secretions, skin lesions of an infected person or recently contaminated objects.

Also read: Explained: How the Centre is prepping for monkeypox as it spreads to 23 countries

Since transmission via droplet respiratory particles usually requires prolonged face-to-face contact, health workers, household members and other close contacts of active cases are at greater risk.

Transmission can also occur via the placenta from mother to fetus (which can lead to congenital monkeypox) or during close contact during and after birth. While close physical contact is a well-known risk factor for transmission, it is unclear at this time if monkeypox can be transmitted specifically through sexual transmission routes, WHO said.

According to the New York Times, a majority of those infected currently are men under 50, and many identify as gay or bisexual, which may reflect the outbreak’s possible origins at a Gay Pride event in the Canary Islands.

Experts have said that the outbreak could just as easily have started among heterosexual people at a large event.

“The risk of exposure is not limited to any one particular group,” said Dr. Rochelle Walensky, director, the Centers for Disease Control and Prevention (CDC).

“Our priority is to help everyone make informed decisions to protect their health and the health of their community, and that starts with building awareness guided by science, not by stigma.”

What is the treatment?

According to the WHO, vaccination against smallpox is about 85 per cent effective in preventing monkeypox. Thus, prior smallpox vaccination may result in milder illness.

At the present time, the original (first-generation) smallpox vaccines are no longer available to the general public. A newer vaccine based on a modified attenuated vaccinia virus (Ankara strain) was approved for the prevention of monkeypox in 2019. This is a two-dose vaccine for which availability remains limited.

Smallpox and monkeypox vaccines are developed in formulations based on the vaccinia virus due to cross-protection afforded for the immune response to orthopoxviruses.

With inputs from agencies

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