Monkey warnings ‘ignored’ and now the world must prepare for more outbreaks: scientists – Reuters

For years, African researchers have tracked a sharp rise in the case of monkey pox.

More than 2,800 suspected cases were reported in 2018 in the Democratic Republic of Congo alone. The following year, they were nearly 3,800.

By 2020 – half a century after the discovery of the first human infection in the Central African country, then known as Zaire – the total number of suspected annual cases was around 6,300, including 229 deaths.

The sharp rise in infections occurred as globalization increased, humans continued to infiltrate animal habitats, and the cross-protection offered by decades-old smallpox vaccination campaigns began to wane. Given this perfect storm, many scientists were not shocked by the recent emergence of monkey pox in other countries around the world.

Some also warn that this will not be the last time the virus spreads beyond its typical territory.

“The recent eruptions are a kind of culmination of many years of warnings that were ignored,” said Dr. Boghuma Titanji, a scientist and physician in infectious diseases at Emory University in Atlanta, originally from Cameroon.

“Because monkey poop is unfortunately a disease that has traditionally caused epidemics in Africa – and usually in very remote parts of Africa – and that affects populations that the world does not always care about.”

The monkey pox virus, known to cause revealing skin lesions, usually infects human populations when someone touches or eats infected wildlife. (Melina Mara / The Washington Post / Getty Images)

“Our fears are confirmed”

The monkey pox virus, known to cause revealing skin lesions, usually infects human populations when someone touches or eats infected wildlife. From there, it can spread through close contact, including respiratory droplets in the air, skin-to-skin contact, or if someone touches contaminated surfaces such as clothing or bedding.

Most researchers studying new viruses have long feared they could “evolve to fill the ecological niche” left behind when a similar virus, smallpox, was eradicated through global vaccination programs, Titanji said. by CBC News.

“If given the opportunity to spread uncontrollably … it can infect humans better and lead to larger outbreaks than we have seen before,” she added.

The prevalence of human monkey pox “increased dramatically” in rural Congo in the decades following the cessation of mass pox vaccination, informed researchers in an article published in 2010 in the peer-reviewed journal Proceedings of the National Academy of Sciences.

In Nigeria, more than 500 cases of monkey pox have been reported since 2017, including a handful of deaths – and the true number may be higher, given limited surveillance of the spread of the virus in rural areas, said Dr Oyewale Tomori, a Nigerian virologist.

“The further we get away from the smallpox vaccine, the more likely it is that smallpox will start spreading,” said Tomori, board member of the Global Virome Project and former president of the Nigerian Academy of Sciences.

“We’ve been saying this for some time. Now our fears are confirmed.”

SE | How monkey cup outbreaks typically unfold in endemic areas of Africa:

A virologist explains how outbreaks of monkey poop typically occur in endemic areas of Africa

Virologist Dr. Oyewale Tomori describes what monkey pox outbreaks usually look like in parts of Africa where the virus is endemic.

Animal migration driven by climate change and deforestation also fuels more human-animal interactions, Titanji said, making it easier for viruses like monkey pox to spread from wildlife to human populations.

“When the world is as interconnected as it is, it takes less than 24 hours for a traveler from an endemic country, such as Nigeria, Cameroon or [Congo]to go to Europe, North America or South America, or anywhere else on the planet for that matter, ”she said.

The spread outside Africa is no big surprise, Dr. Beatrice Nguete, a physician and monkey poop researcher at the Kinshasa School of Public Health in the Congolese capital.

“All communicable diseases have the potential to disappear,” she said. “You have someone visiting an endemic [area]or an area where an outbreak has occurred – you have that option. “

Recent increase in global travel

But why right now?

Cases of monkey pox have appeared sporadically in other countries before, usually travel-related, but not on the scale of the current outbreak in several countries where local infection is evident.

Hundreds of cases have been reported so far across several continents, mostly in men, and more than 50 confirmed or suspected infections are currently under investigation in Canada.

There is as yet no concrete evidence that the virus has mutated, according to World Health Organization (WHO) officials, although global teams are still analyzing samples.

Instead, Dr. David Heymann, one of the WHO’s top advisers and former head of its emergency department, recently proposed that the unprecedented global outbreak was a “random event” and probably associated with transmission by raves held in Europe.

A teenager is being examined by a doctor on suspicion of monkey pox in the Republic of Congo in August 2017. (Melina Mara / The Washington Post / Getty Images)

People can sometimes be contagious with monkey pox for up to a month, including a day or two before skin lesions appear, giving the virus plenty of time to spread. This means that a high number of cases in Africa and greater mobility after a long break during the journey during the COVID-19 pandemic can provide the ideal conditions for its rapid spread.

“We are seeing a very large increase in global travel that we have not seen in the last three years,” noted Dr. Abdu Sharkawy, infectious disease specialist at the University Health Network and assistant professor of medicine. of Toronto.

Given the unusual nature of current transmission patterns, it is also possible that the virus spread globally, undetected, for some time, until clinicians outside Africa realized this. They saw, said Dr. Michael Libman, director of the JD MacLean Center for Tropical Medicine at McGill University in Montreal.

“If it have developed in one way or another, which may make it a little different from what we have previously dealt with in Africa, ”he said.

WHO warns of ‘further transmission’

The lingering questions surrounding the current global epidemic make it difficult to predict how it will develop. But monkey poop outbreaks in Africa generally tend to fluctuate, Tomori of the Global Virome Project said.

“We don’t see fast transmission like you see with COVID, for example,” he said. “But it also dies almost within a few months after a generation or two after spreading … then it suddenly reappears.”

Officials in Canada, the United Kingdom and several other countries also pursues ring vaccination strategies to cut the chains of virus transmission by vaccinate certain high-risk individuals – such as close contacts of people suspected of infection – with smallpox vaccines.

Still dr. Hans Henri P. Kluge, WHO Regional Director for Europe, issued a statement Tuesday highlights its concern about the “potential for further transmission in Europe and elsewhere over the summer”, given the number of major parties and festivals expected in the coming months.

SE | How does ring vaccination work? :

How ‘ring vaccination’ could help limit the spread of monkey pox in Canada

“Ring vaccination,” rather than mass vaccination used for COVID-19, is the likely way to limit the spread of monkey pox in Canada, says Dr. Samir Gupta.

“From now on, an effective response to monkey pox will not require the same broad population measures that we needed for COVID-19 because the virus did not spread in the same way,” he continued. “But – and this is important – we do not yet know if we will be completely able to limit the spread.”

Officials from the European Center for Disease Prevention and Control also warn that if monkey pox spreads to local wildlife, it could become endemic to this continentjust like in parts of Africa – refers to when a virus is constantly circulating in a particular region.

“If current trends continue – and there is no reason to believe that they should not – we will see many more cases and we will see them in very different geographies,” the official said. “U of T’s said Sharkawy.

Given the possibility of continued spread and future outbreaks, Emory University’s Titanji said it was crucial that the global public health community pay more attention to the transmission of the virus from animals to humans, both for monkey pox and other new pathogens.

“When these epidemics in North America and Europe end, will we then go back to ignoring the contagious events that have taken place for 50 years in Africa?” she asked.

“Or will we invest more significantly to better track the virus – and better protect these populations – to really stop contagion at their source?”

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