We quickly blew the chance to contain Monkeypox. Now this dangerous virus is spreading rapidly around the world.
Health experts agree: The outbreak could soon qualify as an epidemic, if it hasn’t already. And the situation is likely to get worse before it gets better. More infections, more deaths, more likely to convert to pox.
“We’re in uncharted territory with this outbreak … and still very early in the event,” James Lawler, an infectious disease specialist and Wiley’s colleague at the University of Nebraska Medical Center, told The Daily Beast.
The latest statistics from the US Centers for Disease Control are startling. The CDC put the number of infections at 9,647 as of July 11. This is a four-fold increase from just a month ago.
“It’s shocking, after what we’ve learned with COVID-19, that we’ve allowed another virus to grow to this point.
– Lawrence Gostin, Georgetown University
The virus, which causes a rash and fever and can be fatal in a small percentage of cases, is present in 63 countries – 57 of which are not normally present. any In the case of monkeypox.
Cases are concentrated in West and Central Africa – where the virus is endemic – as well as in Europe, where the current outbreak first began in May. But the US has had a staggering number of cases, as well: 865 in 39 states, according to the CDC. Which is five times compared to a month ago.
“Monkeypox is clearly a global health emergency,” Lawrence Gostin, a global-health expert at Georgetown University, told The Daily Beast. “It has spread to small pockets of central and western Africa for decades, but until now there have been no cases that have been associated with travel to the rest of the world. Now it’s in virtually every region of the world, and spreading rapidly.”
The death rate, please, is still low. As of July 4, the most recent date for which figures are available, the World Health Organization has recorded only three deaths in the current outbreak.
Three of the 9,647 — or .03 percent — West and Central African countries have had a much lower death rate than their own pox outbreaks have seen in recent decades. Involving a strain of the virus endemic to the Congo River basin in central Africa, the worst African outbreak has officially resulted in a fatality rate of up to 10 percent.
But the more viruses spread, the more they mutate — often in ways that make them deadly. As long as monkeypox spreads faster than health authorities can contain it, it risks giving rise to new, more dangerous forms, potentially increasing the death toll.
Monkeypox is mostly spread through close physical contact, especially sexual contact. it is no But a sexually transmitted disease. It only takes advantage of skin-to-skin contact with sex. The virus can also travel short distances in spit, though probably not enough to qualify as “airborne.”
Officials first noticed the current outbreak in early May after a UK traveler returning from Nigeria was diagnosed with the relatively mild West African strain of pox. Traveling to Europe, the virus spread rapidly through physical contact.
David Hayman, who previously headed the WHO’s emergencies department, said men attending raves in Spain and Belgium had “exacerbated” the outbreak – apparently through close, sometimes sexual, contact with other men.
After that, the virus accompanied passengers on flights to far-flung countries. Doctors diagnosed the first case in the US on May 27.
But it is now clear that the first diagnosis The original cases of smallpox were not the first in Europe and the United States. On June 3, the CDC announced that it had obtained genetic evidence in a US case of pox that preceded the first case in Europe from May.
Doctors may not notice or report these earlier cases because of the similarity between the symptoms of pox and the symptoms of some common sexually transmitted diseases, such as herpes. In other words, the current outbreak started, and spread, without anyone noticing at first.
The virus had a big head start, which helps explain why, months later, it still has the advantage. “By the time we recognized cases were happening, we were already behind,” Lawler said.
Rapid diagnosis is the key to quickly containing dangerous viruses. If officials know where the virus is concentrated in the early days of an outbreak, they can isolate infected people, conduct contact-tracing to identify vulnerable populations and deploy therapies and vaccines to treat the infected and protect the uninfected. (Lucky for us, widely available smallpox vaccines work just fine against monkeypox.)
By cutting off its potential transmission vectors through early intervention, the virus withers and disappears—before It may mutate into some new variant that may, say, be more infectious or even evade the vaccine.
Should have been in April or earlier did not Because the WHO, CDC, and other health agencies didn’t even know there was an outbreak of smallpox. The current, rapid proliferation is the result of that initial failure.
The worst outcome is not hard to imagine. Ten thousand cases can quickly turn into one lakh cases. Then a million. Different experts and organizations disagree on the precise definition of “pandemic,” but it’s increasingly likely that a smallpox outbreak qualifies now—or will qualify in the coming weeks. At that time, the world will simultaneously fight the pandemic.
WHO for one has studiously avoided using the P-word to describe outbreaks of smallpox. The CDC did not immediately respond to a query
That’s a mistake, Lawler said. “We certainly cannot cry wolf and declare every disease outbreak that crosses multiple international borders an ‘epidemic,'” he admitted.
But, he added, “I would argue that we should have learned some humility in the face of the emerging virus now.” If the word “pandemic” grabs people’s attention and underscores the growing risk – use it.
The silver lining in the current pox outbreak is that the death rate is very low. This may be a statistical anomaly resulting from the large number of deaths in previous African outbreaks. “I’m not sure we have a full understanding of the denominator of cases actually occurring in West Africa,” Lawler noted. This means, it is possible that the death of smallpox in Africa was much more widespread than we realized at the time.
It’s also possible that we’re seeing a happy side-effect of the pox outbreak affecting mostly wealthy communities. “Monkeypox is now being diagnosed in urban populations where more people have access to health care facilities,” Blossom Damania, a virologist at the University of North Carolina at Chapel Hill, told the Daily Beast.
Either way, we should not be complacent. Like all viruses, pox treats each infected person like a laboratory. A chance to try new things, learn and change. Each additional infection increases the likelihood of new forms emerging. As COVID has shown time and time again, new forms mean new risks. Greater transmissibility, severity, or vaccine-viability—or a combination of all three.
There is still time to prevent the worst-case scenario of millions of cases and potentially thousands of deaths. The WHO, CDC and other health agencies must redouble efforts to educate doctors and speed up diagnosis — and then move more quickly to isolate and treat infected people and vaccinate those around them. “If we can get enough vaccine for high-risk contacts, it will stop,” Amesh Adalja, a public health expert at the Johns Hopkins Center for Health Security, told the Daily Beast.
Covid has reminded us how bad a viral outbreak can be. Then comes Monkeypox to remind us of our strong tendency toward complacency, even in the midst of an ongoing health crisis. “It’s shocking that, as we’ve learned with COVID-19, we’ve allowed another virus to become a global health emergency,” Gostin said.
To catch up with the fast-moving pox, what we need now – more than anything – is a new sense of urgency.