Mint Explainer: Can Covid Lessons Help Fight Monkeypox?

Declaring it a public health emergency on 23 July, WHO Director-General Tedros Adhanom Ghebreyesus said, “At the moment it is an outbreak that is concentrated in men who have sex with men, especially those with multiple sexual partners.” But the U.S. Cases have also been reported in children, triggering concerns that it may spread beyond homosexuals and bisexuals. There is now an approved vaccine in the US and Europe, but demand is expected to outpace supply, as has already been seen in the US. Experts are talking about social distancing and masks again. India has also reported few cases and cannot be complacent.

With all the lessons learned from the COVID crisis, can the world stop the monkeypox from snowballing?

What is monkeypox?

It is a disease caused by monkeypox virus. The name monkeypox comes from its early origins. It was first discovered in 1958 among a group of laboratory monkeys kept for research. The first case in humans was reported a decade later in 1972. Monkeypox is a viral zoonotic infection, and it can be spread from animals to humans.

The monkeypox virus comes from the same virus family that causes smallpox. This is the reason why smallpox vaccines are effective in fighting monkeypox as well. However, similar to smallpox, the symptoms of monkeypox are mild and rarely cause death. Monkeypox has nothing to do with chickenpox as some people mistakenly believe.

Before this year’s outbreak, cases of monkeypox continued to occur in Central and West African countries. Previously the spread of cases beyond Africa was largely the result of international travel to countries where the virus was endemic.

Already this year, there have been more than 16,000 cases in 75 countries, forcing the WHO to label it a “Public Health Emergency of International Concern” (PHEIC). Under the International Health Regulations 2005, countries are legally obliged to take a notice. PHEIC and this often leads to a concerted global movement against a disease with the pooling of financial and medical resources. This is the seventh PHEIC declaration by WHO since 2009, after H1N1 (2009), Poliomyelitis (2014), Zika (2015), Ebola. (twice, 2013 and 2018) and COVID-19.

How is monkeypox spread? What are the symptoms?

Common symptoms of monkeypox are fever, headache, muscle aches, back pain, fatigue and swollen lymph nodes. It is accompanied by rashes on certain parts of the body such as the face, eyes, mouth, throat, groin and genital and anal areas. Symptoms usually persist for two to three weeks and gradually disappear on their own, although fever or pain may require certain medications. People remain contagious until all the painful sores are gone and replaced by a new layer of skin.

According to the WHO, monkeypox is spread by close contact, including face-to-face, skin-to-skin, mouth-to-mouth, mouth-to-skin and sexual contact. An infected person can contaminate everything around them with the monkeypox virus, from surfaces to objects to clothing to electronic devices. The virus can spread through respiratory droplets and short-distance aerosols, although scientists are still trying to understand how it spreads through the air.

A study in the New England Journal of Medicine shows that the vast majority of infections (over 90%) are transmitted through sexual contact—about 98% of those infected in the study were gay or bisexual men. But experts have cautioned against stigmatizing a certain section of people. Here’s what the WHO says: “The virus is spread not only by sexual contact, but also through close contact with someone who is contagious. Individuals living in the same household are at greater risk. People who have symptoms of monkeypox should seek advice from a health worker immediately.” During pregnancy, from mother to fetus, or from parent to parent during close contact with monkeypox can also be spread to an infant or child. .

WHO says fragments of DNA from monkeypox virus have been found in semen, but it is not yet known whether the infection can spread through semen, vaginal fluid, amniotic fluid, breast milk or blood . The WHO says those at high risk for serious illness or complications include those who are pregnant, children, or those with immune systems.

Monkeypox can be spread to people through physical contact with an infected animal, as has been observed in West and Central Africa. Animal hosts have mainly been rodents and primates.

How effective are vaccines?

Newer and safer smallpox vaccines have also been found to be effective against monkeypox. In fact, one of them is specifically approved for monkeypox—Genios in America, manufactured by Bavarian Nordic. The European Union also on Monday approved the vaccine, which was marketed as Imvanex. But meeting the growing demand for the vaccine will be a big challenge. Already, there are long queues outside clinics in the US amid a huge shortage of two-dose Jynneos.

Smallpox vaccination was discontinued globally after the disease was eradicated in 1979. Vaccine production was also stopped. It is not known whether India has the capacity to produce a large number of smallpox vaccines if necessary.

For now, not everyone can be vaccinated. The WHO states that only people who are at risk (for example, someone who is in close contact with someone who has monkeypox) should be considered for vaccination. It does not recommend mass vaccination.

The US Food and Drug Administration (FDA) has warned of caution on vaccines. In the US, along with Genios, another vaccine—ACAM2000—is available, but it may have serious side effects. The USFDA states that ACAM2000 can cause myocarditis and pericarditis. In addition, people who have recently been vaccinated with ACAM000 can also infect those uninfected with the vaccine virus in close contact. There may be some side-effects of Jynneos vaccine such as muscle pain, headache, tiredness, nausea, and chills.

Singapore has warned about the benefits of the vaccine. Singapore’s Ministry of Health (MOH) does not recommend mass vaccination against monkeypox. “As of now, given the self-limiting nature of the disease, the MOH does not recommend mass vaccination against monkeypox of the entire population, as the benefits do not outweigh the risks,” Health Minister Ong Ye Kung said on Monday. “

How can you avoid getting infected?

The way to prevent infection with monkeypox is in some ways similar to fighting covid. Since it spreads through close people-to-people contact, social distancing and wearing of masks is already being advised by many experts in public places. A surgical mask would work, although apparently N95 is the safest. The risk of catching monkeypox from animals can be reduced by avoiding unprotected contact with wild animals, especially sick or dead (including their flesh and blood). As another precaution, any food containing animal meat or parts should be thoroughly cooked before eating. Thermal scanners can also help monitor people in public places for early signs of illness.

India has come out with detailed guidelines to prevent the spread of monkeypox. People with symptoms such as fever and skin rash in the area where monkeypox has been reported should contact the nearest health facility immediately.

The Kerala government has also issued detailed SOPs. Anyone with fever and red spots at international airports will be shifted to the nearest hospital with isolation facilities. Doctors will have to wear PPE kits and patients will have to wear N95 masks. In addition, international travelers have been advised not to eat or prepare meat from wild game (shrub meat) or use products (creams, lotions, powders, etc.) from wild animals from Africa.

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