Hogle Zoo animal care staff member Jill Cox shows off a female giant Gambian rat in Salt Lake City.

Here’s Why Scientists Aren’t “Crazy Afraid” of Monkeypox

The monkeypox outbreak has captured the attention of an anxious public struggling to emerge from the COVID-19 pandemic and on high alert for the next virus that could turn our lives upside down.

Fortunately, the professionals are much calmer about monkeypox than the armchair experts.

“Over the past two years, everyone has become a virologist,” said Paula Cannon, a bona fide virologist at USC’s Keck School of Medicine. “We don’t have to be crazy scared.”

Unlike the situation two years ago with the then novel coronavirus, scientists already know about this virus. They know that monkeypox is nowhere near as transmissible as COVID-19, or particularly deadly. They know how it spreads and how it can be stopped.

The outbreak intrigues people like Cannon for a very specific reason: they want to understand why it’s suddenly popping up in unexpected places in North and South America, Europe, the Middle East and Australia.

Thousands of people contract monkeypox each year through close contact with infected people or animals, mostly in rural areas of West and Central Africa. Even in areas where access to health care is extremely limited, the survival rate is well over 90%.

Cases have already been discovered in the United States and Europe, but they have always been quickly linked to people who have recently traveled to a place where the virus is endemic or who have interacted with infected animals.

The last major outbreak of monkeypox in the United States, in 2003, was traced to pet prairie dogs that contracted the virus from infected animals imported from Ghana to Texas as pets. All 47 human patients survived.

A giant Gambian rat at the Hogle Zoo in Salt Lake City. Gambian rats are one of the species suspected of having introduced the monkeypox virus to the United States in 2003.

(Douglas C. Pizac/Associated Press)

The current epidemic, in which more than 400 cases have been reported worldwide, is a little different. Few, if any, patients have traveled to areas where the virus is known to be present or have been in contact with infected animals.

The first US case was documented in a man from Massachusetts who recently traveled to Canada, where at least 26 cases have been confirmed so far.

California’s first case, an individual who health officials say recently traveled to Europe, presented in Sacramento County on Tuesday. At least 10 other cases have been identified in Colorado, Utah, Florida, Virginia, Washington State and New York City. Samples are sent to the Centers for Disease Control and Prevention for confirmatory testing.

Most patients in the current outbreak are in Europe, with more than 100 in the UK. Other cases have emerged in more than a dozen countries, including Spain, Portugal, Germany, the Netherlands, Argentina, Israel and the United Arab Emirates, according to the World Health Organization. health and Global.health, an international research team funded by Google.

Despite its evocative name, monkeypox is more common in rodents than in primates – a group of laboratory monkeys in Copenhagen were found to be the first animal confirmed to have smallpox in 1958.

A week or two after exposure, infected people have fever, chills, muscle aches, and swollen lymph nodes. A few days after the fever begins, patients develop pustule-like lesions that usually start on the face and spread all over the body before crusting over and falling off. Patients are not contagious until the first symptoms appear and the disease usually runs its course in two to four weeks.

It is a less deadly cousin of smallpox, a much more vicious virus that has killed around 30% of those infected. Thanks to vaccines, smallpox was declared eradicated worldwide in 1980.

Ironically, this success has opened the door for similar viruses, like monkeypox, to creep into the human population.

Vaccines that protect against smallpox also work against its weaker cousins, but they haven’t been part of standard childhood vaccinations since the 1970s. There just hasn’t been a need for them. Therefore, most people under the age of 50 are not immune to this type of virus.

“The eradication of smallpox was of course one of the greatest achievements in public health history, but it also left the door open for other viruses to fill the void. As a result, we have waning population immunity to smallpox viruses,” said Anne Rimoin, an epidemiologist who has studied monkeypox for the past two decades and directs the UCLA Center for Global and Immigrant Health.

In other words, she says with a sad laugh, “no good deed goes unpunished.”

People crowd into a room to get vaccinated against smallpox in New York City in 1947.

New Yorkers line up to get vaccinated against smallpox in 1947.

(Tony Camerano/Associated Press)

As outbreaks occur, monkeypox is far less potent than COVID-19.

When SARS-CoV-2 emerged in Wuhan, China in late 2019, it was a brand new coronavirus. Scientists had to start from scratch to figure out what it was, how it was spreading and how it could be contained – all while a global health catastrophe unfolded.

By contrast, scientists already know that monkeypox spreads far less easily than coronavirus and can be effectively contained with existing vaccines, which are still given to people at risk of coming into contact with the virus while traveling or working. of laboratory.

The CDC has already stockpiled enough smallpox vaccine to fight a widespread outbreak. There is no specific treatment for monkeypox, but vaccination after exposure appears to lessen the severity of the disease.

The question for public health officials is: Where did the current outbreak come from and what will the virus do next?

The search for answers is a lot like “looking at a distant star,” Rimoin said. The events that led to today’s infections took place weeks ago; epidemiologists don’t know what’s going on right now that may or may not cause the disease to spread.

You cannot catch monkeypox from an infected person in the office or on the street. Transmission requires close physical contact or prolonged intimate exposure to an infected person, their bedding or clothing. Hours of dancing in very close quarters could transmit the virus; just like sexual contact. A significant number of the currently reported cases appear to be linked to attendance at two raves in Europe.

For now, it appears “the virus was lucky – it found some big parties or festivals that allowed it to take off,” said UCLA infectious disease biologist Jamie Lloyd-Smith. “Then he flies under the radar because no one is looking for him. What doctor in Madrid sees someone with a rash and thinks monkeypox? No one, until last week.

Early sequencing shows that the type, or clade, of the monkeypox virus responsible for this outbreak is similar to that of a 2018 outbreak in Nigeria. It does not appear to have mutated into a more easily transmitted form.

Monkeypox is endemic in less densely populated rural areas, Rimoin said. Will it behave differently in an urban, mobile population? Will the virus evolve as it moves through a new environment?

“That doesn’t necessarily mean these things will be felt. That’s why we carefully monitor these viruses,” Rimoin said. “We need to be able to ensure that we don’t allow a smallpox virus to establish itself in places where it is not already endemic.”

The most valuable tools against the spread are vaccines and data. Outbreaks like this are why strong and constant public health surveillance is needed.

“If we have good public health surveillance systems in place and these things can be monitored, then we can nip things in the bud and stop things from spreading,” Cannon said.

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