More than 3000 confirmed or suspected cases of monkey pox have been identified worldwide, 167 in the Netherlands. Should we be concerned?
What is monkey pox?
Monkeypox is caused by a virus related to smallpox† As the name suggests, it was first identified in monkeys. It is mainly restricted to West and Central Africa.
Why is it in the news?
Last Wednesday there were in the Netherlands according to the RIVM identified 167 cases of monkey pox† On that day, there were more than 3,000 confirmed or suspected cases of monkeypox known worldwide since the outbreak began, according to a list of reports compiled by associate professor of computational and genomic epidemiology. Moritz Kraemer from the University of Oxford in the UK, professor of biomedical informatics John Brownstein of Boston Children’s Hospital and their colleagues. The cases come from the Americas, Australia, Africa, the Middle East, parts of Asia and Europe.
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What are the symptoms?
A monkeypox infection is usually mild. Most people recover without treatment within 14 to 21 days. Early symptoms include fever, headache, muscle aches, back pain, swollen lymph nodes, chills, and exhaustion.
You can get a chickenpox-like rash, which often starts on the face and then spreads mainly to the hands and feet. The rash goes through several stages and develops into thickened skin and fluid-filled pimples. Eventually, scabs form and fall off.
How serious is the disease?
Monkeypox is therefore normally a mild disease from which you can recover without treatment within a few weeks. There are two main types: the Congo tribe and the West African tribe. The World Health Organization (WHO) states that monkeypox has a reported death rate of between 1 and 10 percent† That applies to the Congo tribe. The West African strain is fatal in about 1 in 100 reported cases.
Amid the ongoing outbreak, information on the DNA sequence of the virus limited. So far, only the West African tribe has been identified.
In addition, it is important to realize that the reported death rates only cover the percentage of deaths among people who have actually been confirmed to be infected: the so-called case fatality ratio† Many people have mild symptoms, and those cases often go unnoticed. Thus, the death rate from the infection, the percentage of deaths among all those infected, can be significantly lower.
According to the WHO children with monkeypox are more likely than adults to become seriously ill. Getting infected during pregnancy can also lead to complications, including stillbirth.
How does monkeypox spread?
You can get monkey pox from infected wild animals in parts of West and Central Africa, for example from being bitten or from touching animal blood, fluid, stains, blisters or scabs. Monkeypox can also be transmitted by eating undercooked meat from an infected animal.
The virus does not transfer from person to person. Nevertheless, it can be transmitted through contact with bodily fluids, blisters or scabs, or by inhaling large airborne droplets — typically no more than three feet, according to the U.S. Centers for Disease Control and Prevention. Touching an infected person’s clothing, bedding, or towels can also be a risk.
Is there a vaccine? And how is monkeypox treated?
In Europe and the United States, a vaccine called Jynneos (also known as Imvanex and Imvamune) has been approved for people over 18 years of age, which helps prevent monkeypox and smallpox infection.
Some people have been vaccinated against smallpox as babies, which should provide some protection against monkeypox. Routine vaccination against smallpox ended in the Netherlands in 1974 (in the UK in 1971 and in the US in 1972).
The antiviral drug is used in Europe to treat monkeypox, smallpox and cowpox tecovirimat (also sold under the brand name Tpoxx). In the US, only smallpox can be treated with this.
Why all the fuss?
Any disease circulating in animals that can be transmitted to humans could trigger another pandemic if the disease mutates and becomes more deadly or more easily transmissible.
Most people expect that monkeypox can be controlled by source and contact research. The infection is also significantly less transmissible than, say, Covid-19, and vaccine and treatment options already exist.
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