New Outbreak of Monkeypox Virus: WHO Declares the Outbreak a Global Health Emergency
Monkeypox is a viral zoonotic disease caused by monkeypox virus. Monkeypox virus is an enveloped double-stranded DNA virus from the Ortho-poxvirus genus of the family Poxviridae, which also includes the variola virus which causes smallpox, the vaccinia virus, which was used for the development of smallpox vaccine, cowpox virus, and camel-pox virus. The virus was named after its discovery in monkeys kept for research purposes in a Danish laboratory in 1958. While the exact reservoir of monkeypox virus is yet to be determined, various animal species and groups including rope squirrels, tree squirrels, Gambian pouched rats, dormice, and non-human primates are known to get infected with and transmit the virus.
Monkeypox virus has developed into the Central African strain and the West African strain, however, neither strain spread beyond tropical rain forest regions of Central and West Africa until 2003. Prior to the current outbreak, while monkeypox virus has sporadically exported to non-endemic areas mainly through international travel and trade, it was quickly contained. The rapidly growing outbreaks of the monkeypox virus in many non-endemic countries has raised major concern. Accordingly, the World Health Organization (WHO) has declared monkeypox a global health emergency on July 23. Read along to learn more about monkeypox infection, the latest information on the outbreaks, and the developments on the global response.
How does monkeypox virus transmit?
Monkeypox virus transmits through close contact with infected animals and humans, or recently contaminated materials. The virus can enter through broken skin, respiratory tract, or mucous membranes such as the eyes, nose, or mouth. Animal to human transmission of monkeypox may involve contact with the blood, bodily fluids, and lesion material of an infected animal. Thus, monkeypox might spread through wounds such as bites and scratches caused by an infected animal. Consuming insufficiently cooked meat or other products from infected animals may also be a potential route for transmission. Human to human transmission is possible through contact with respiratory secretions, bodily fluids, and skin lesions of an infected person. In addition, monkeypox may also transmit from the mother to fetus through the placenta. The growing spread of monkeypox in non-endemic countries has suggested that the virus may be spreading through unknown transmission routes. While direct sexual intercourse has not been identified as a transmission route, latest data suggests that close contact during sexual activity may have accounted for a substantial amount of transmissions in the current outbreaks.
What are the symptoms of a monkeypox infection?
Symptoms of monkeypox infection typically include fever, chills, headaches, back pain, myalgia, swollen lymph nodes, fatigue, and a rash that may resemble blisters on various parts of the body such as the face, inside the mouth, hands, feet, chest, genitals, and anus. The incubation period between the initial exposure and the onset of symptoms is usually 5 to 21 days, and symptoms typically last for 2 to 4 weeks.
How many monkeypox cases have been detected so far?
According to Centers for Disease Control and Prevention (CDC), as of 22 Jul 2022, there are 16,836 confirmed cases in 74 countries around the world. Moreover, 16,593 of the confirmed monkeypox cases are reported from 68 non-endemic countries in total. According to the World Health Organization (WHO), the number of confirmed infections jumped around 77% between late June and early July. Europe currently accounts for more than 80% of the confirmed cases worldwide. Most cases have been reported from Spain (3125), the United States (2890), Germany (2268), the United Kingdom (2208), and France (1567).
Is there a vaccine against monkeypox virus?
There are various vaccines such as JYNNEOS and MVA that have been approved for use against smallpox and monkeypox disease. These vaccines can offer protection against smallpox, monkeypox, as well as other diseases caused by ortho-poxviruses, are currently targeted particularly at persons at high risk. Due to cross-protection afforded for the immune response to ortho-poxviruses, vaccines designed for smallpox and other ortho-poxviruses were found to be around 85% effective in preventing monkeypox.
If I have been vaccinated against smallpox as a kid, am I protected against monkeypox virus?
As mentioned above, monkeypox virus belongs to the same family with the virus that causes the smallpox disease. As the two viruses are related, the smallpox vaccine is known to offer protection against monkeypox. In fact, the smallpox vaccine has shown more than 85% efficacy against monkeypox disease. However, since routine smallpox immunization for the general public have widely stopped many years ago, health experts warn that smallpox vaccines that have been received then may not offer sufficient protection against the monkeypox virus.
Which treatment options are available against monkeypox?
Although the data on their efficacy is still scarce, antiviral agents such as cidofovir and tecovirimat are also considered as potential options in the treatment of monkeypox, as both agents have proven to be effective against poxviruses. Developed originally for the treatment of smallpox, tecovirimat was recently licensed by the European Medical Association (EMA) to be used in the treatment of monkeypox.
Which testing options are available for the diagnosis of monkeypox infections?
Rapid antigen testing, and molecular testing such as polymerase chain reaction (PCR) are available methods for the diagnosis of monkeypox infections. With the growth of the monkeypox outbreak, efforts to provide diagnostic testing for the specific detection of monkeypox virus has accelerated. Although there is currently no self-test for the detection of monkeypox, various tests based on molecular and antigen detection methods have recently become available for professional use. Utilizing samples collected from the skin lesions of the patient, these tests can have significant benefits for pandemic management and public health by facilitating timely access to care and rapid identification of close contacts.
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What are the latest developments in monkeypox outbreak response?
On July 23, the World Health Organization (WHO) has declared monkeypox a global health emergency of international concern, which is the highest alert level of the organization. Although the United Nations agency declined to declare monkeypox a global emergency last month, new monkeypox infections around the world has rapidly grown since then. This declaration indicates that the threat posed by the current monkeypox outbreaks are significant enough to call for a coordinated international response to prevent further transmission. The agency has reported that even though the global threat of monkeypox currently remains moderate, the threat in Europe is high. Moreover, while the emergency is not likely to restrict global trade or travel for now, there is still a risk that monkeypox continue to spread around the world. The declaration of the World Health Organization (WHO) does not impose requirements or restrictions on national governments. Still, it functions as an urgent call for cooperated international action against the outbreaks.