What we know so far – POLITICS

Just when the world thought the worst of COVID was over, an outbreak of another virus is worrying scientists.

Cases of monkeypox have been confirmed in the UK, Portugal, Sweden, Italy, Spain, France, Belgium, Germany, US, Canada and Australia.

What experts are concerned about is the unusual spread of the disease. Monkeypox mostly circulates in Africa, with occasional individual cases associated with travel abroad. But according to the EU’s disease control agency, recent cases in Europe appear to have spread from person to person for the first time, with no direct link to Africa. In addition, health authorities in a number of countries have noted that the spread appears to be concentrated among gay or bisexual men.

According to British media, public health officials in the UK have made an urgent appeal to virologists to volunteer to scale up the response to the monkeypox outbreak, while the World Health Organization holds daily meetings about the rapidly changing situation.

POLITICO digs into what we know so far.

What is monkey pox?

Monkeypox is a disease caused by a virus that belongs to the same family as smallpox.

The symptoms of monkeypox usually begin with a fever, aching muscles, swollen lymph nodes, and headache. Typically, within one to three days after the fever starts, a distinct bumpy rash begins to develop — often starting on the face — and spreads to the hands and feet.

However, monkeypox is less deadly than smallpox. The West African type that scientists have discovered in Europe has a mortality rate of just under 4 percent. So far, no deaths have been reported in the recent European outbreak, but monkeypox can leave patients bed-bound for days. The illness usually lasts between two and four weeks.

Where are the cases?

In this most recent outbreak, the UK became the first country to detect a case of monkey pox on May 6. Since then, a total of 20 people with the disease have been found in the country. The UK Health Security Agency said these cases were mostly among gay or bisexual men. The virus was also found elsewhere in Europe. Portugal reported 14 cases of monkey pox and Spain confirmed 30 cases. Italy has three confirmed cases, Belgium two, and France and Sweden have confirmed each case so far. Germany’s first case has been identified in Munich, Health Minister Karl Lauterbach confirmed at a G7 press conference on Friday.

Canada’s Public Health Agency confirmed two cases in the country. A case has also been reported in the US, where the man recently traveled to Canada, while other possible cases are being followed. Australia reports two confirmed cases.

Why are experts concerned?

The concern, expressed by virologist Marion Koopmans, is the fact that monkeypox cases have been detected in several countries, as monkeypox is usually not very contagious. Koopmans, head of the viroscience department of Erasmus MC, tweeted Thursday that the outbreak is “starting to become alarming.” She said that in the past, the occasional imported cases usually didn’t spread further. “In this situation, new cases have been discovered in several countries,” she said. “That’s very unusual.”

Koopmans said it could be that monkeypox has become more transmissible and that there is an “urgent need” for more information.

This concern was shared by Germany’s Lauterbach: “Only genetic studies will show … whether the infectious pathway has changed,” he told the press.

This information seems likely to come next week. Francesco Vaia, director of Italy’s National Institute of Infectious Diseases, the Lazzaro Spallanzani Institute, told a news conference Friday that their virology lab expects to isolate the virus next week. This will also allow testing to see whether antibodies from smallpox vaccination can neutralize the virus, he said.

Concerns have also been raised about whether this virus evolved to be transmitted both sexually and through close contact. “We’re studying it, doing sperm research,” Andrea Antinori, director of the Viral Immunodeficiency Department at the Lazzaro Spallanzani Institute, told the press conference in Italy.

More broadly, Michael Head, senior research fellow in global health at the University of Southampton, said the imported cases “indicate a broader burden of disease elsewhere in the world.”

“In a post-pandemic environment, we may need to pay more attention to understanding the local and global implications of lassa, monkeypox, Ebola and other rare but serious pathogens,” he said.

What do experts recommend?

The ECDC is asking public health groups to raise awareness of monkeypox in communities of people who identify as men who have sex with men, who have multiple sexual partners, or who have casual sex.

Monkeypox is not known to be sexually transmitted, the head of the University of Southampton said earlier this week, commenting on the British cases. “It’s more that here the close contact during sexual or intimate activities, including prolonged skin-to-skin contact, may be the most important factor during transmission,” he explained.

Jimmy Whitworth, professor of international public health at the London School of Hygiene & Tropical Medicine, said the outbreak in the UK was “unprecedented”. However, he said if the cases were identified, isolated and treated, as well as close contacts identified and monitored, it “could be brought under control quickly”.

In countries where vaccines against smallpox are available, the ECDC recommends considering vaccination of high-risk close contacts after a risk-benefit assessment. And if antivirals are available, they should be considered for treating severe cases, the agency said. In the UK, some health professionals, as well as other contact persons at risk, are offered smallpox vaccines. In Spain, El País newspaper reported that the country’s health ministry is preparing to purchase thousands of doses to contain the outbreak.

In Italy, Vaia said the country has antivirals ready to use experimentally “if needed.”

This article has been updated.

This article is part of POLITICAL PRO

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