Monkey pox: 3 questions in regards to the virus, new in Europe

We are talking more and more about monkeypox. Nearly a hundred cases have been listed in Europe and North America. The virus, whose symptoms are pimples that can be impressive, is not very lethal, and there are treatments.

Since mid-May 2022, the name of a new disease has been on everyone’s lips: monkeypox. Also called varicella in English, the associated virus has been found in nearly a hundred people in Europe and North America. In France, there is currently one confirmed case, as of May 23, 2022, although several other suspected smallpox cases are being examined. There are currently no serious cases or deaths to be mourned in Europe and North America.

Despite this, the news about the disease is numerous and can be worrying, remembering the beginning of the Covid-19 pandemic. Currently, there is no real comparison to be made between the two diseases: Numerama explains it all.

What is monkeypox?

First, you have to take stock of the disease. Monkeypox is a disease known to health services for a long time: the first human cases were detected in 1970 in the Democratic Republic of Congo. It is therefore a virus that has been known for over 50 years.unlike Covid-19, which was a new virus from the coronavirus family.

The number of monkeypox cases recorded by country, between 13 and 21 May 2022. // Source: WHO

Monkeypox is ” an infectious disease, due to an orthopoxvirus, characterized in particular by a rash that occurs within 1 to 3 days after the onset of fever “, describes the Ministry of Health. These rashes can take the form of pimples and irritations, and form mainly on the face (in 95% of cases, according to the WHO), palms of the hands and soles of the feet (in 75% of cases), mouth (70% of cases), genitals (30% of cases) and eyes (20% of cases).

The pimples that form can be quite painful and fluid-filled. They also remain in the body for a long time: the WHO indicates that symptoms can last between 2 and 4 weeks. In addition to skin symptoms, monkeypox also causes fever, severe headache, swollen lymph nodes (located in the neck, groin, and armpits), back pain, muscle pain, and severe fatigue.

The disease is transmitted from animals to humans through contact with blood, fluids, or lesions on the skin of an infected animal. But monkeypox is also transmitted from human to human: the disease is contracted through close contact with patients, mainly through droplets (saliva, sneezes, spit). The varicella it can also be transmitted indirectly, or by touching clothes that have been in prolonged contact with sick people (bedding, clothes, dishes, bath towels, etc.).

The case fatality rate of monkeypox is low: it is between 0 and 11%, although young children are more severely affected. The WHO specifies that the most recent death rate is between 3 and 6% of cases..

Could it become a pandemic, like, for example, covid?

Monkeypox is a virus that circulates mainly in Africa. Since its discovery in 1970, most cases have been recorded in the Congo Basin region, in the rainforests, but more and more cases are being reported in the Central and West African regions, according to the WHO.

However, this is not the first time smallpox cases have been reported outside the African continent. The first smallpox outbreak outside Africa was reported in 2003 in the United States, when a man was bitten by an infected prairie dog. In all, more than 70 cases were listed at the time. But that’s not all: Monkeypox was also reported in Israel and the United Kingdom in 2018, in Singapore in 2019 and in the United States in 2021, traces the WHO.

But the cases identified this year are different, explains Camille Besombes, an infectious disease specialist who has been involved in the Afripox project, launched by the Institut Pasteur and whose mission is to study monkeypox, in The Conversation. ” The first case of the current outbreak, which occurred on May 7 in the UK, was a traveler returning from Nigeria. But since then, several other cases have been confirmed in the UK without it being possible to establish a link to the 7 May case or between them. No foreign travel compatible with contamination could be demonstrated, and direct chains of transmission could not be established. This situation suggests that there are several chains of transmission and autochthonous circulation of the virus. »

A map representing the number of detected cases by country. // Source: WHO

But is this cause for concern? For Camille Besombes, “it isThis autochthonous circulation of the disease is completely new “, especially as the cases identified so far concern “ almost exclusively young men, most of them declaring themselves to have sex with other men “. However, one case in a woman was reported in Spain, and ” Transmission can also occur during heterosexual intercourse. “. It is important to note that nothing allows, at the moment, to say that the virus is sexually transmitted, like HIV.” Intimate and close contact during intercourses” would explain the contagion at that time, explains Camille Besombe.

As of now, there are no plans or spread scenarios for monkeypox like there are for covid. This is a first for the researchers, and the new cases do not correspond to defined chains of transmission. ” The there is a real risk that new infections will emerge in countries already affected or in other countries in the coming days or weeks “Warn Camille Desombes.

However, it is not certain that the number of new cases will increase exponentially. ” Smallpox outbreaks quickly die on their own », indicates Camille Desombes. ” The longest chain of transmission identified spanned 7 generations, i.e. 7 humans transmit the disease consecutively before transmission stops.. »

Are there treatments for monkeypox?

Another reassuring point: there are treatments to combat monkeypox. An antiviral drug known as Tecovirimat was approved in January 2022 by the European Medicines Agency (EMA) and its American equivalent, the FDA. The Tecovirimat” is effective in reducing mortality from smallpox, monkeypox, and cowpox, based on animal studies “, specifies the EMA decision.

However, this is just a marketing authorization. in exceptional circumstances “That was issued for Tecovirimat, notes the European Medicines Agency. ” In fact, it was not possible to obtain complete information about Tecovirimat due to the rarity of these diseases. Each year, the Agency will review all new information available and, if necessary, update this overview.. »

Electron micrograph of monkeypox virus particles isolated in 2003 in the United States from human specimens. // Source: The Conversation / Cynthia S. Goldsmith, Russell Regner / CDC / AP

If there is no other antiviral effective against smallpox, it is possible to get vaccinated. The smallpox vaccine offers cross-protection: a 2007 study estimated it would provide 65% protection. For the moment, ” the vaccine most likely to be implanted, if necessary, is the so-called ‘3and generation’, Imvamune “, says Camille Desombes in The Conversation. It is an attenuated vaccine, which can be administered to immunocompromised people, and which has already been used in Israel, Singapore and the UK on healthcare workers and contacts of imported cases “. The vaccine’s effectiveness is currently being evaluated in the Democratic Republic of Congo, where health personnel were inoculated.

And, last good news, smallpox” being a DNA virus, it is less likely to mutate than RNA viruses like SARS-CoV-2 “, says Camille Desombes. Covid-19 mutations such as Delta or Omicron have made the virus more contagious and more virulent.

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