Monkeypox: Why we should be worried
Rise in global incidents ringing alarm bells among disease experts
In a world still on edge from the Covid-19 pandemic, the emergence this week of a scattering of cases of a different disease jumping from animals to humans has put global health experts at action stations.
Victims are being struck with fevers, aches and pains and then a rash of ugly fluid-filled bumps and lesions that spread across the skin.
The infection has originated this time not from bats in China, as with the coronavirus, but probably from rodents in Africa. The resulting disease — called monkeypox — has been known for decades, but the current smattering of cases is unexpected because of its wide geographic spread and it is ringing alarm bells.
Until now, monkeypox has been known to be mainly concentrated in a handful of African countries, including Nigeria and the Democratic Republic of the Congo, with cases only rarely exported elsewhere. This time, however, cases have quickly cropped up in the United States and four European countries and the wide distribution suggests it is spreading undetected.
So how worried should the world be about monkeypox? Disease experts warn that, while it may not be about to trigger another Covid-like pandemic, it is likely to spread further and needs to be taken seriously.
Jimmy Whitworth, a professor of international public health at the London School of Hygiene and Tropical Medicine, said that meant the current international outbreak was “highly unusual”.
“It has only happened eight times in the past before this year.”
While he says the cases are not likely to cause an epidemic like Covid, he warns that it is “a serious outbreak of a serious disease — and we should take it seriously”.
Matthew Ferrari, director of the Centre for Infectious Disease Dynamics at Penn State
University, added: “What we’re seeing may not manifest as a largescale catastrophe. But we’re seeing a predictable phenomenon that is a stark reminder that emergence events are not black swans and we must plan accordingly.”
By May 19, the UK had logged nine cases, Portugal had recorded 14, Spain seven.
The United States and Sweden have each reported one. Italian authorities have confirmed one case and suspect two more.
Disease experts say that this wide array of new cases is one source of concern and points to the virus having been already spreading undetected for some time. Only the first of the UK victims had recently travelled to Africa, meaning the others caught it from domestic spread. Two of the cases live together, but there’s no direct contact between the rest.
Bill Hanage, an epidemiology professor at Harvard, said: “These are the largest, most disseminated outbreaks of their kind we have seen. It is obvious that we should be making protective vaccines now.”
He wrote on Twitter that it was “very plausible that transmission has been happening for some time unnoticed because folks don’t expect to see monkeypox and so don’t diagnose it”.
He went on: “Now on the bright side this implies that the severity of the infections are not extremely high or we would have noticed sooner. On the gloomier, it means there are multiple transmission chains out there already that means lots of infections and, as we should have learned from recent experience, even if an infection is mostly mild that is scant comfort if you get so many of them the rare poor outcomes add up.”
Monkeypox is a rare, usually mild infection, related to the dreaded smallpox which was eradicated in 1980. Monkeypox is typically caught from infected wild animals in parts of Africa. Symptoms usually start after five to 21 days and include a fever, a headache, muscle aches, backache, swollen glands, shivering and exhaustion. A chickenpox-like rash of raised spots often starts on the face and spreads, turning into small blisters filled with fluid. These blisters eventually form scabs which later fall off, according to the NHS website.
In more extreme cases, the disease can sometimes be fatal. There are two varieties: a Congo strain, which is more severe and may kill up to one in 10, and a west African strain, which has a fatality rate in about 1 per cent of cases.
Monkeypox gained its name because it was first discovered in 1958 in monkeys kept for research, but signs of infection have also been found in various rats, mice and squirrels.
The first human case was recorded in 1970.