Just as India was coming to terms with the “new normal” of living with Covid-19, the arrival of monkeypox has not just put health authorities on alert but also triggered panic among people. India reported its fourth monkeypox case as a 34-year-old man from Delhi with no history of foreign travel tested positive for the virus. The man had attended a stag party recently in Himachal Pradesh’s Manali. Three previous cases have been reported from Kerala among nationals who returned home from the Middle East.
Raising an alarm, the World Health Organisation’s (WHO) Regional Director of South-East Asia Region called the rapidly spreading cases a “matter of concern” and appealed to countries to strengthen surveillance and public health measures for the disease. Globally, over 16,000 cases of monkeypox have been reported from 75 countries.
“Monkeypox has been spreading rapidly and to many countries that have not seen it before, which is a matter of great concern. However, with cases concentrated among men who have sex with men, it is possible to curtail further spread of the disease with focused efforts among at-risk population,” Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region said.
The WHO has declared the outbreak a public health emergency of international concern (PHEIC), its highest level of alarm.
News18 takes a look at the virus and why it’s spreading but not as fast as Covid-19:
Q.Is monkeypox new?
Unlike Covid-19, a novel disease, the first monkeypox infection was identified in 1970 in the Democratic Republic of Congo in a nine-month-old boy. Most infections initially were caused by interaction of humans and animals in rural, rainforest regions of the Congo basin. The first outbreak outside Africa happened in 2003 when the United States saw over 70 cases.
Q.What do we know about the disease?
The symptoms of monkeypox, a self-limiting viral infection, last 2–4 weeks and the case fatality ratio ranges between 0 and 11%.
Fever, headache, muscle ache, back pain, low energy, and swollen lymph nodes, along with rashes that last for 2–3 weeks are some of the most common symptoms. Although mostly mild, it can lead to complications — such as pneumonia, sepsis, encephalitis and infection in cornea leading to blindness — and deaths in children and those with a weak immune system.
Q.Like Covid-19, can a vaccine help?
The monkeypox virus belongs to the orthopoxviruses family, which are cross-reactive. This means the existing vaccine for smallpox, which is now eradicated, can be used for monkeypox.
The US, which has recorded over 2,800 cases, is using two vaccines meant for smallpox. Jynneos with two doses is allowed for use in adults, while ACAM2000 uses a live, attenuated form of a different orthopoxvirus and is meant for protection of high-risk individuals for smallpox such as lab workers.
According to the WHO, “Vaccination against smallpox was demonstrated through several observational studies to be about 85% effective in preventing monkeypox. Thus, prior smallpox vaccination may result in milder illness.”
Q.How does it spread?
The infection is transmitted from animals to humans through direct contact with blood, bodily fluid, or lesions in the infected animals. A large respiratory secretion or contact with lesions of an infected person can led to human-to-human transmission.
Q.Will it spread as fast as Covid-19?
Transmission of monkeypox through respiratory droplets needs prolonged face-to-face contact, unlike in the case of coronavirus.
According to doctors, monkeypox will not be as transmissible as coronavirus and thus the chances of an outbreak were limited. However, they suggest that one must probe if Covid-19 is behind weakening the immune system in such a way that bodies have become more susceptible to infection.
Dr Nivedita Gupta, head of virology at the Indian Council of Medical Research (ICMR), had told News18.com in May this year that monkeypox will not spread like wildfire, but vigil has been stepped up across India.
“The virus won’t spread like wildfire as we feared for coronavirus,” said Gupta, adding “the virus requires large droplets to cause infections and hence is not much transmissible”.
“Also, a prolonged face-to-face contact with the disease carrier is required, which in many cases is unlikely. Hence, its spread is not as rapid as Covid-19.”
Dr Rosamund Lewis, the WHO’s lead expert on monkeypox, has called for research to see whether there was a change in the virus, or whether this was happening because of the declining number of people immunised against smallpox.
Q.Is it sexually transmitted?
Although the WHO says it is unclear if the infection is transmitted sexually, it is under investigation with almost all cases in the current outbreak being reported in gay or bisexual men. A recent analysis of 528 persons from London, published in the New England Journal of Medicine, shows 98% of those infected were gay or bisexual men and suggests transmission in 95% cases happened through sexual activity. In 29 of 32 persons whose semen was analysed, monkeypox DNA was found.
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