Imminent threat of renewed Monkeypox outbreak remains, experts warn

By Al Mayadeen English
Source: Agencies
21 Oct 2022 22:43

Monkeypox has usually been spread via human contact, but in African regions, the virus is mostly spread through contact with animals, especially rodents in rural zones.

Monkeypox retreating but threat remains, experts warn

Although the monkeypox outbreak has been receding globally in recent months, experts have been warning against an imminent threat that the virus may resurge as some African countries are still faced with this burden as it has long been endemic.

The World Health Organization said this week that since the month of May, more than 73,000 cases and 29 deaths have been recorded in over 100 countries.

The virus peaked in July, followed by a consistent fall in total cases, especially in the European and North American continents which were the hardest hit areas in the early stages of the global outbreak.

The number of new global cases fell by 20% in the seven days up to Sunday compared to the previous week, the WHO said.

In some areas, cases are still increasing to unusual frequencies, as in the South American country of Peru where cases rose to 7% during that short timespan.

"We are heading towards the end, but we are not there yet," Jean-Claude Manuguerra, head of the environment and infectious risks unit at France's Pasteur Institute, told sources.

WHO chief Tedros Adhanom Ghebreyesus said last week that "a declining outbreak can be the most dangerous outbreak because it can tempt us to think that the crisis is over, and to let down our guard."

Progress of #monkeypox index lesion:
A) on the 4th day of illness
B) on the 6th day of illness
C) on the 18th day of illness
D) Necrotic scab underneath the devitalized tissue of the index lesion on the 24th day of illness
3/7#resident #medicine pic.twitter.com/TIE5vMh1xK
— Antonio Guerrero (@guerreroespejo) October 20, 2022

Experts agree that changes in behavior by at-risk communities were an essential factor in reducing the number of cases.

NGOs also took an active role in raising awareness as they were "closer to the ground and perhaps more listened to than the authorities," according to Manuguerra. A virologist at the UK's Surrey University, Carlos Maluquer de Motes, said vaccinating against monkeypox "has helped, but the number of available doses remains low."

Even though the vaccines were originally developed to fight smallpox, they are still recommended to protect against monkeypox - though evidence of their effectiveness is "still lacking", according to the European Centre for Disease Prevention and Control (ECDC).

The US Centers for Disease Control and Prevention said last month that unvaccinated people were 14 times more at risk of getting monkeypox.

Historic smallpox vaccination and monkeypox virus infection elicit monkeypox-neutralizing antibodies, but these responses are less frequent and of lower magnitude after vaccination with MVA-BN, according to a @NatureMedicine paper. https://t.co/OtCr6xo7PZ pic.twitter.com/1PC0yDUh0z
— Nature Portfolio (@NaturePortfolio) October 20, 2022

According to the ECDC, there are four possible scenarios for the outbreak to re-emerge.

One of these scenarios, and the "worst" according to the ECDC, would be that monkeypox has a resurgence worldwide as the behavior of at-risk groups returns to normal.

A second scenario is that the virus stays at low levels with sporadic outbreaks.

Third is that the virus would wave, and fourth it would be eliminated completely.

Unlike Covid, monkeypox is less contagious and does not evolve into new variants as fast as covid.

But "the more cycles of infection there are, the more likely monkeypox is to change and adapt," Maluquer de Motes said.

Sadly, the most affected countries where most deaths have been reported are the 11 African countries where it remains endemic.

In other parts of the world, monkeypox has usually been spread by humans, but in African regions, the virus mostly spreads via animals, especially rodents in rural zones.

Steve Ahuka-Mundeke, the head of virology at the Democratic Republic of the Congo's medical research institute INRB, said the source of the virus in Africa remains.

"We may have new exported cases and a new outbreak wave at any time," he said.

Recently, "we have again seen that global strategies are only deployed when northern countries are affected which does not at all absolve the African health authorities," he added.