Yes, we could predict monkeypox -

Yes, we could predict monkeypox –

It seems to have come out of nowhere, to the point that some people are looking for an invisible hand behind these events. But the appearance of monkeypox in the European and North American news was only a matter of time. For at least a decade, notes the rumor detector.

It’s called “monkey” pox because scientists first identified it in monkeys in 1958. But it’s spread mainly in small rodents. The first confirmed case of a human being dates back to 1970 in the Congo. However, since the symptoms resemble those of smallpox, cases may have been seen for centuries but have been mistaken for smallpox.

Until a few weeks ago, it was a disease confined almost exclusively to the African continent, of which two strains were known: the one said to be from the Congo basin, more virulent, and the one said to be from West Africa, which currently occupies all minds. . The fact that it is almost exclusively an African disease explains why much of the European and North American public has never heard of it before. But the experts themselves observed its evolution and on several occasions had sounded the alarm.

a predictable event

In 2003, the first outbreak outside the African continent was even reported: 47 confirmed cases in six US states, including Wisconsin and Indiana. It had its origin in the importation of small mammals from Ghana. But in the absence of other similar events thereafter, the virus had fallen into oblivion.

However, as early as 2010, a study reported a “strong growth” in the number of cases in the Congo. In 2017, the virus was observed in Nigeria for the first time in at least 20 years: some experts today speak of it as an uninterrupted outbreak since that date and probably underestimated (officially about 560 cases between 2017 and April 2022).

In 2018, a report by the US Centers for Disease Control, commissioned in the context of the Nigerian outbreak, expressed concern that more countries had reported cases “over the last 10 years than over the 40 years.” previous”. Since the publication of this report, isolated cases have originated in Nigeria in Great Britain, Israel, and Singapore.

Two Belgian researchers spoke of it in 2018 as an emerging disease to watch out for. A review of the literature in 2019, covering 71 documented outbreaks in Africa over decades, also found an increase.

Finally, a meta-analysis published last February estimated that, since the 1970s, the number of cases would have multiplied by 10 in Central and West Africa, where the virus is now considered endemic, that is, permanently present. The increase is particularly marked in the Congo, which only registered 28,000 cases between 2000 and 2019.

An indirect cause of this growth, already mentioned in 2010, could be the eradication of smallpox: after eradicating this disease throughout the world -whose mortality rate was 30%-, the vaccination campaigns that now have more than 40 years. However, the smallpox vaccine also seemed to protect against monkeypox: we would then find ourselves, 40 years later, with a large part of the population that has never been immunized against these viruses.

There is little data to test this hypothesis, as monkeypox has gone unrecognized for a long time. But it is an idea defended by several experts for years. And the 2010 study, which looked at medical data from the Congo from 2005 to 2007, estimated that people vaccinated against smallpox were five times less likely to get monkeypox.

Lack of interest outside of Africa

All this explains why, in recent days, African experts have been surprised by the sudden anticipation of a virus that, to them, is nothing new. “The enthusiasm” for fighting this virus “should have come earlier,” he said on May 24 in the Washington Post Christian Happi, Cameroonian expert in gene sequencing. “Perhaps it could already have been eradicated. »

This lack of interest has translated into a lack of resources for “genomic surveillance” in Africa – contrary to what we have seen with COVID for the last two and a half years – complains the director of the Center for Disease Control. Diseases of Nigeria. Ifedayo Adetifa, in the newspaper Nature. Other African virus experts “expressed irritation that they had to fight for years to get funding and publish studies on monkeypox”, and only now do health authorities around the world seem interested.

Fearing the epidemic is not a prediction

However, the concerns of the experts have led several groups or governments to finance actions in recent years. And some of them in recent days have caught the attention of conspiracy theorists, in the Twittersphere in particular where they affirm that this epidemic was planned.

For example, Internet users believed they detected signs of conspiracy in the fact that the Canadian government launched tenders for smallpox vaccines in April. Or in the fact that an American non-governmental organization had organized 2021 a virtual simulation exercise of a terrorist attack with monkeypox.

Except for epidemic preparedness scenarios, they have been everywhere and have been around for a long time, some based on fictitious viruses, others on credible epidemics. For example, an exercise developed by Johns Hopkins University in 2017 involved a coronavirus, inspired by the SARS outbreak of 2003-2004. Finally, after the September 11, 2001 attacks in New York, there was even a fear that terrorists might use smallpox as a weapon.

It is in this dual context—fear of the return of smallpox and fear of monkeypox—that governments maintain stockpiles of vaccines that were once and hopefully effective against smallpox. As noted by the French fact-checking site Done and Furiousthe Canadian government’s call for bids in April is just the latest in a long list going back to 2014. And if we were to decide to believe that this new order placed in April was proof that the epidemic was planned, we would at the same time acknowledge that the order would arrive too late: the manufacturer is committed to delivering 500,000 vials of the vaccine from 2023… to 2028.

In the post-COVID era

Without paying enough attention to monkeypox in the last decade, we can predict that the tide will turn in the coming weeks and months. This could benefit detection and tracing efforts in African countries where it is endemic. In addition to research efforts: among other things, it is still unknown why one of the two strains is so much more virulent than the other. An enigma that could be important, insofar as, for the time being, only the least virulent strain has been observed outside the African continent.

And it is not said that this interest cannot last for years. On May 23, while stressing that the risk posed by the virus to the population is “low”, the European Center for Disease Prevention raised the possibility that monkeypox could become endemic in Europe, in the same way. so it is in 11 African countries. countries. We may not have finished hearing about it.

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