Monkeypox: What to know about the virus discovered in the United States

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Massachusetts health authorities said Wednesday they have confirmed a case of a rare and sometimes dangerous viral disease called monkeypox — the first infection identified in the United States this year amid a string of cases outside the disease’s typical region.

Monkeypox, which can be transmitted to animals and humans, is usually found in central and western Africa. But health authorities in Europe have confirmed more than a dozen cases this month and are investigating dozens of others. Some Officials said confirmed infections in the UK had “no travel links” to a place where monkeypox is regularly found, suggesting the virus may be spreading through the community.

It is not known that monkeypox is easily spread between humans. The fact that cases are emerging in so many countries simultaneously – with signs of “sustainable” transmission between humans – is astonishing, said Aris Katzurakis, professor of evolution and genomics at Oxford University.

“Either there is a lot of misfortune or something unusual is going on here,” Katzurkis said.

Monkeypox is named after the animals in which it was discovered. The disease emerged in 1958 among monkeys kept for research, according to the Centers for Disease Control and Prevention — more than a decade before a human case was discovered in the Democratic Republic of the Congo.

In a 2005 article, researchers wrote that mass vaccination of smallpox had curbed monkeypox infection for some time in humans. But they say cases have resurfaced, thanks in part to immunodeficiency in later generations. More than 450 cases have been reported in Nigeria since 2017, according to the Centers for Disease Control and Prevention.

CDC scientists traveled to this remote African village to search for the monkeypox virus

The Centers for Disease Control and Prevention says monkeypox infection usually lasts two to four weeks, beginning with flu-like symptoms. Symptoms and swollen lymph nodes. The fluid-filled bumps — or “pox” — eventually spread through the skin.

Health authorities say the disease can be spread through contact with infected animals, people, and materials used by infected people. Examples listed by the CDC include contact with bodily fluids, contact with monkeypox sores, and infection through “respiratory droplets” in a “nearby” such as a shared home.

Monkeypox can be fatal, but the two main strains of the virus pose different risks. About 1 in 10 people infected with the Congo Basin strain have been found to die, according to the World Health Organization, while the West African strain appears to be fatal to about 1 in 100 infected people.

Health authorities have said it is this milder strain that affects people who have been hospitalized in the UK. It is not clear what strain the Massachusetts patient had.

How should we be concerned? How does this compare to Covid-19?

Experts assert that monkeypox is different from the Corona virus, which turned the world upside down.

Monkeypox is highly visible, which makes contact tracing and isolation easier. Katzorkis said the current smallpox vaccine could help protect the public if needed. “We don’t have the possibility of something spreading around the world at anything like the kind of rate we’ve seen with the Covid virus,” he said, because monkeypox is easily transmitted between humans.

However, the latest wave of cases is emerging, Katzwerkis said. The longer it persists, the greater the chance of the virus mutating and improving its transmissibility, just like the new coronavirus.

Tom Inglesby, director of the Johns Hopkins Center for Health Security, said monkeypox outbreaks were usually small, with the number of patients in the single digits. “So I think the risk to the general public at this point, from the information we have, is very, very low.”

But he agreed that the recent issues raise many questions. “We don’t have a sense yet of what’s driving it. There is no travel link identified that brings all of these cases together,” he said.

Health officials have noted recent cases among men who have had sex with other men — a pattern necessary to understand, Inglesby said, since officials had not previously considered sexual orientation to be a risk factor for monkeypox.

Has monkeypox ever reached the United States?

Monkeypox made its way to the United States — and the Western Hemisphere — for the first time in 2003, researchers said. More than 70 cases have been reported in the Midwest, most of them among people exposed to prairie dogs that appear to be infected with ferrets from Ghana, according to the CDC. on diseases.

The Centers for Disease Control and Prevention said two children became seriously ill and recovered.

The infection reported Wednesday in Massachusetts is the first case of monkeypox to be identified in the United States this year, health officials said. The Massachusetts Department of Public Health reported that Texas and Maryland reported one infection each year in “people who have recently traveled to Nigeria.”

Rare monkeypox virus reported in Dallas

Where else was monkeypox identified this month?

The United Kingdom and Portugal have announced confirmed cases, while Spanish authorities said on Wednesday they were investigating more than 20 suspected cases. Officials said the first known patient in the UK had recently traveled to Nigeria.

The World Health Organization said the person developed a rash in late April, shortly before leaving Africa. The World Health Organization said on Monday that people identified as contacts had not yet reported “consistent symptoms”.

But more cases have emerged.

British health authorities announced two new infections on Wednesday, for a total of nine confirmed infections in England since May 6. The agency said there were no clear links between the last two patients and previous confirmed cases or countries in which monkeypox typically occurred — raising the possibility of monkeypox. community transmission.

The UK Health Security Agency (UKHSA) said the latest cases were “mostly in gay, bisexual or MSM”. The agency advises people in those groups to be “especially alert for any unusual rashes or lesions on any part of their body.”

The World Health Organization said it was aware of seven confirmed or probable cases – including three in one family – that appeared to be “locally acquired in the UK”.

Meanwhile, Portugal’s Directorate General of Health said more than 20 “suspected cases” have been identified this month. The agency confirmed the injury of five of them, and the injuries are concentrated among young people.

What do we know about the US case?

The Massachusetts Department of Public Health said in a statement that the man who had recently traveled to Canada was tested for the virus on Tuesday, and the CDC confirmed the infection on Wednesday.

CDC medical officer Ajam Rao told the Washington Post on Wednesday that the CDC is monitoring six Americans after sitting on a plane near a British patient. None of the patients showed signs of monkeypox symptoms.

US officials said doctors should consider diagnosing monkeypox in people who have an unexplained rash, who have traveled to a country with a confirmed case, been in contact with someone who may have been infected or who had sex with other men.

The CDC works with counterparts in other countries to gather information that can answer experts’ many questions.

“We are still early in all of this to really understand its scope and its cause,” Rao said. “We’re very much in a response mode where we’re trying to identify cases, identify potential contacts, and make sure we’re making the right recommendations for all of those people, including the health care personnel looking after the patient.”

The disease is so rare, said Inglesby of Johns Hopkins University, that “most doctors in America will never see a case in their lifetime” — so communication about monkeypox will be important in ensuring doctors monitor symptoms.

Another top priority, he said, is: getting more information about any links between distant infections. Is the disease spreading from West and Central Africa to other countries independently? Or do issues spread through networks of people?

“It’s going to be really important for us to understand that, because once you understand how cases are spreading … it gives us a chance to intervene,” Inglesby said.

Obtaining the genetic sequence of the virus behind the latest cases will help scientists verify whether they are dealing with a new strain of monkeypox. Inglesby said that unlike the flu or the coronavirus, researchers haven’t noticed much change in monkeypox over the years, “and it will be important to make sure that’s the case.”. “

Thanks to global trade and travel, experts said, smallpox viruses are able to spread farther. The eradication of smallpox in 1980 helped the remaining smallpox viruses bypass dwindling protection measures, said Ann Rimoen, a UCLA epidemiologist who has studied monkeypox for two decades.

“No good deed goes unpunished,” said Raymoine. “You’re proclaiming that you can eliminate the pathogen, but you can leave room for another to emerge.”

While researchers have found a rise in the prevalence of monkeypox since the end of the smallpox vaccine campaign, other factors have been linked to the infection, including climate change and other environmental shifts that have led to more human-animal interactions, Rao said.

“We are now at a point where we really need to know why this is happening before we can start proposing solutions, such as vaccines,” Rao said. “This is unexpected. It is not something we would have recommended if you asked me two weeks ago because the risk to the general public is extremely rare.”

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