Monkeying Around Monkeypox!

Monkeypox is a disease caused by the infection of monkeypox virus. It belongs to the genus Orthopoxvirus and family Poxviridae. The genus Orthopoxvirus also includes variola virus, which causes smallpox and vaccinia virus that was used in the manufacture of smallpox vaccine, and cowpox virus.

It was first reported in monkeys maintained in a laboratory for research in 1958. The first human infection of it was reported in 1970 when a nine-month old child from Democratic Republic of Congo, was infected. Nigeria too reported a monkeypox infection in humans in 1970 and two more in 1978.  

For almost four decades thereafter, there was no reporting of monkeypox. But in 2017 it re-emerged in Nigeria. Between September 2017 and April 30, 2022, it has reported 558 cases. Among them, 231 have been confirmed by laboratory. Since then, dozens of cases were reported from Nigeria year after year.

Based on the clinical examination of confirmed cases from Nigeria during 2017-2018, researchers have found that the virus transmits primarily from an infected animal or from an infected person. Transmission from animal to man occurs through broken skin or through direct contact with an infected animal’s blood, bodily fluids, or pox lesions. Man to man transmission occurs when one comes in contact with the sores, sobs, respiratory droplets or oral fluids of an infected person. One may even pick it up by coming into contact with recently contaminated clothing, bedding and other clothes used by an infected person.

Bill Hanage, Associate Professor of epidemiology from Harvard TH Chan School of Public Health, commented that many early cases were noticed among gay or bisexual men, and people with multiple sexual partners. There is however no evidence to indicate that the virus transmits through semen or vaginal fluids. It is believed that it is the skin-to-skin contact during sex that might have resulted in the virus spread.

Epidemiologists say that it may take several days to a few weeks for an infected person to develop symptoms. Early signs of infection may look-like flu-like symptoms: fever, chills, headache, muscle aches, fatigue, and swollen lymph nodes. After a few days, a rash often develops. Rash may start as flat, red-bumps and they may be painful. Later, these bumps may turn into blisters which fill with pus. Over a period of two to four weeks, the blisters may crust over and fall off. One may also get sores in mouth, vagina or anus.

In the current outbreak of the disease, it is noticed that all the infected persons need not necessarily develop all these symptoms. Some may have relatively few blisters than what is normally expected. With the result, there is a likelihood of misdiagnosing it as other infectious disease. Here the danger is the infected man though not showing any symptoms could still transmit the virus to others. Of course, the rate of spread of the disease by an infected person is still not known. It is only with the spread of the disease from Africa to Europe and North America, that researchers have noticed large-scale human-to-human transmission. 

But what is most intriguing about this disease is: while monkeypox outbreak was noticed in Nigeria as early as in 2017 and subsequently dozens of cases were reported from time to time, no international attempt was made to stop the outbreak in Nigeria, nor did any agency paid requisite attention to research the disease till the latest outbreak in Europe and North America,. Even to date, the host animal of the virus that acts as its reservoir is not known. In the light of this, African scientists’ accusation that till wealthy countries are effected by the disease, no one had paid attention to study the disease and its spread sounds true.

For, it’s only after the disease was spread to Europe and America that the researchers from Portugal uploaded the first draft genome of the monkeypox virus detected in the country. But as Gustavo Palacios, virologist from the Icahn School of Medicine at Mount Sinai, commented, more work needs to be done to draw definitive conclusions about the disease. All that the researchers are saying today based on the preliminary genetic data is that the virus found in Portugal is related to a viral clad that was predominantly found in West Africa, which was found to cause milder disease with a lower death rate of 1% in rural population.

Of course, it is still not known for certain if this is the same strain that is causing concern across England and North America. True, currently genome sequencing is being carried out actively, and till date 15 genomes are reported to have been sequenced. And theoretically. this being a DNA virus, mutation rate would not be that alarming as in the case of RNA-virus. However, nothing is still known about its mutation rate for certain. So, what is needed is more research to know about its source animal and causes under the current occurrence of the disease in the hitherto non-endemic countries.

Despite the fact that the current spread of the monkeypox disease is commented by virologists as an “eye-opening” kind, scientists believe that it would fizzle-out on its own: it will not spread that easily between people and there is a vaccine to prevent it and it is easily noticed when somebody’s got it. They say it would not certainly become a pandemic. Let us join them in that hope but keeping ourselves well informed about the latest findings about the disease.

That said, we must also remember that once a new disease is noticed—be it in Africa or elsewhere—threatening mankind, it is incumbent upon the rich nations to show solidarity by undertaking requisite research for its control….. For, it is a matter of a few months for a new disease to spread to the rest of the world from its place of origin.....