Are you bored of the covid epidemic? Do you pine for a simpler time when hundreds of millions died of a disease that could not be treated? Well you are in luck as we now have Monkeypox to deal with.
The World Health Organization (WHO) chief said on Wednesday that monkeypox infections in non-endemic countries have passed the 1,000 mark and the risk of it becoming established in some is “real”.
Some points we could discuss:
Should we change the name?
Monkeypox does not have much to do with monkeys. It was first identified using laboratory monkeys, but the main reservoir in the wild is rodents: So far, however, only six wild animals trapped in Africa have yielded the virus: three rope squirrels, a Gambian rat, a shrew, and a sooty mangabey monkey. Antibodies to the monkeypox virus are most abundant in African squirrels.
However it is endemic in Africa, and considering the history of the use of terminology relating to Africans this does seem problematic. We have stopped calling covid variants after places, and even excluded a greek letter because of one guy, so it seems there is precedent.
Monkeypox is NOT an STI
The current outbreak has some association with men who have sex with men, and it does require closer contact than covid, but it is not an STI. In the UK all suspected monkeypox cases are being sent to the clap clinic, which is putting them under strain as they are not set up for the this sort of disease, that can be contracted during a consultation. I wonder if it is the governments attempt to stop people panicking by making out it is a problem for those other people that are different from good tory nuclear families.
To vaccinate or not to vaccinate
The only real intervention we have for monkeypox is the smallpox vaccine, the original live vaccine is about 85% effective against contracting the disease. There are new vaccines that are non-replicating and are much safer (but untested vs monkeypox), but the vast majority of the 100 million or so doses of smallpox vaccine that are avialable are still the vaccinia replicating vaccine, and this has serious side effects like encephalitis or progressive vaccinia in about 1 in 25,000 people IIRC. In the current outbreak many contacts of those infected are living with HIV, which could make them more likely to suffer from vaccinia side effects. Given the risks and benefits, “using these vaccines is out of the question”.
Animal reservoirs outside Africa?
In Africa the problem is that it is endemic in rodents, so it cannot be eliminated in humans only. In the 2003 outbreak a number of individuals in the United States caught the virus from infected prairie dogs purchased from pet shops where the animals had been in contact with monkeypox-carrying Gambian pouched rats imported from Ghana. Could we end up with it endemic in American or European rodents?
Why is it spreading now?
It seems to me that the covid restrictions should reduce the chance of such spread. Why has it happened now? Could it be a change in the virus? We do not know:
As monkeypox threat grows, scientists debate best vaccine strategy
Concern grows that human monkeypox outbreak will establish virus in animals outside Africa
Monkeypox: ‘This is an entirely new spread of the disease’
UK gov advice
WHO Monkeypox page
Nature questions page
Nature update 8th June
The World Health Organization (WHO) chief said on Wednesday that monkeypox infections in non-endemic countries have passed the 1,000 mark and the risk of it becoming established in some is “real”.
Some points we could discuss:
Should we change the name?
Monkeypox does not have much to do with monkeys. It was first identified using laboratory monkeys, but the main reservoir in the wild is rodents: So far, however, only six wild animals trapped in Africa have yielded the virus: three rope squirrels, a Gambian rat, a shrew, and a sooty mangabey monkey. Antibodies to the monkeypox virus are most abundant in African squirrels.
However it is endemic in Africa, and considering the history of the use of terminology relating to Africans this does seem problematic. We have stopped calling covid variants after places, and even excluded a greek letter because of one guy, so it seems there is precedent.
Monkeypox is NOT an STI
The current outbreak has some association with men who have sex with men, and it does require closer contact than covid, but it is not an STI. In the UK all suspected monkeypox cases are being sent to the clap clinic, which is putting them under strain as they are not set up for the this sort of disease, that can be contracted during a consultation. I wonder if it is the governments attempt to stop people panicking by making out it is a problem for those other people that are different from good tory nuclear families.
To vaccinate or not to vaccinate
The only real intervention we have for monkeypox is the smallpox vaccine, the original live vaccine is about 85% effective against contracting the disease. There are new vaccines that are non-replicating and are much safer (but untested vs monkeypox), but the vast majority of the 100 million or so doses of smallpox vaccine that are avialable are still the vaccinia replicating vaccine, and this has serious side effects like encephalitis or progressive vaccinia in about 1 in 25,000 people IIRC. In the current outbreak many contacts of those infected are living with HIV, which could make them more likely to suffer from vaccinia side effects. Given the risks and benefits, “using these vaccines is out of the question”.
Animal reservoirs outside Africa?
In Africa the problem is that it is endemic in rodents, so it cannot be eliminated in humans only. In the 2003 outbreak a number of individuals in the United States caught the virus from infected prairie dogs purchased from pet shops where the animals had been in contact with monkeypox-carrying Gambian pouched rats imported from Ghana. Could we end up with it endemic in American or European rodents?
Why is it spreading now?
It seems to me that the covid restrictions should reduce the chance of such spread. Why has it happened now? Could it be a change in the virus? We do not know:
Understanding whether there is a genetic basis for the virus’s unprecedented spread outside Africa will be incredibly difficult, says Elliot Lefkowitz, a computational virologist at the University of Alabama at Birmingham who has studied poxvirus evolution. Researchers are still struggling to determine precisely which genes are responsible for the higher virulence and transmissibility of the Central African strain compared with the West African one more than 17 years after they identified a difference between the two.
References:
As monkeypox threat grows, scientists debate best vaccine strategy
Concern grows that human monkeypox outbreak will establish virus in animals outside Africa
Monkeypox: ‘This is an entirely new spread of the disease’
UK gov advice
WHO Monkeypox page
Nature questions page
Nature update 8th June
Spoiler Table of countries and counts :
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