The most crucial point I can make is this: don't freak out.
Yes, monkeypox is comparable to smallpox in some respects (more on that below), but it is not nearly as infectious, and we are far better at handling it now than we were just a few years ago. The following factors are thought to have contributed to its emergence:
Why are instances of monkeypox spreading across Europe and the United States?
Monkeypox is no longer as uncommon in Central and West Africa,[1] affecting a wide range of small animals, including squirrels, Gambian pouched rats (also notable for sniffing out land mines), and others. It's probable that rising population pressures and human encroachment on native bush have resulted in greater exposure.
Africa's healthcare system is overburdened. COVID-19 has muddled matters even further, and it's possible that cases, fatalities, and the impact of COVID-19 on healthcare services have been under-reported. When it comes to the basic epidemiological surveillance and management that characterizes most of Africa, stretched services perform worse.
Smallpox vaccine provides roughly 85% protection against monkeypox, but since we've eradicated smallpox, we've ceased vaccinating, resulting in an increase in the number of persons susceptible to monkeypox.
Because many individuals are acting as though the SARS-CoV-2 epidemic is gone, they are mixing more freely again, allowing monkeypox to spread.
Surprisingly, many of the persons who contracted monkeypox and disseminated it in the United Kingdom, Spain, and Portugal were gay. This does not rule out the possibility of monkeypox being spread through sexual contact. Here are some more monkeypox images:
Although monkeypox resembles smallpox in appearance, it is usually milder. Smallpox used to kill roughly 30% of those who contracted it (although there was a minor variant called alastrim where the death rate was less than one tenth of that). Monkeypox might resemble chickenpox, but it is distinguished by the presence of swollen lymph nodes. Children are more badly impacted, although there is typically no damage if they recover (unlike smallpox).
Monkeypox appears to have two variants, one that kills about 10% of people (the "Congo basin clade") and the other that is much milder, killing under 3% and likely under 1%. The new outbreaks appear to be from the "West African clade," a milder version. [3]
Unless we absolutely screw up the epidemiological management of this disease—uhh, as we mainly did with COVID-19—or this turns out to be a far more aggressive new variation, or both, the outbreaks are likely to be stopped by simple epidemiological procedures. They are, admittedly, having difficulty locating contacts in the United Kingdom. However, because the virus's R0 is believed to be less than one, it is unlikely to propagate rapidly.
Furthermore, that 3–10 percent death rate occurs in the poorest parts of Africa, where health treatment is generally inadequate. For severe situations, we now have cidofovir, albeit a major study is needed to see how well it works. JYNNEOS, a vaccination, is also available. [4] It has received FDA and EMA approval.
Tecovirimat was recently licensed by the European Medicines Agency (EMA) for use in "exceptional situations."
[5] The FDA was more enthusiastic and authorized it in 2018,[6] owing to fears about what the Russians could do next. The United States has several million doses of the medication on hand.
Perhaps we'll be able to do a large-scale trial of one of these medications for monkeypox.
But I wouldn't be concerned.
Dr Jo.
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Footnotes
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