What do we know about monkeypox?

1. What is monkeypox?

Also called monkeypox (simian orthopoxvirus), this disease was first detected in the 1950s, when two outbreaks occurred in colonies of monkeys used for research purposes. The first human case was reported in 1970 in the Democratic Republic of the Congo (DRC).

Monkeypox is endemic to West Africa and is generally rare in other parts of the world.

This disease, also called smallpox, is often considered a mild form of smallpox. Recall that the World Health Organization (WHO) declared smallpox eradicated from the world in 1980.

2. What are the symptoms?

Reported symptoms consist of skin lesions in the mouth and genitalia similar to those caused by chickenpox. These symptoms may be preceded or accompanied by fever, night sweats, headache, swollen glands, and joint or muscle pain.

The incubation period varies from 5 to 21 days. An infected person can be contagious five days before the first symptoms and continue to be contagious for as long as they have skin lesions.

Most patients are not hospitalized, and symptoms usually eventually resolve without treatment.

However, very rare cases of serious complications can occur. For severe infections, there are some experimental antiviral treatments, such as tecovirimat, cidofovir, or brincidofovir.

The mortality rate for this (West African) strain of the disease is 1%. The mortality rate is somewhat higher in children and in immunosuppressed people.

3. How many cases are there??

The first case of monkeypox outside Africa was detected in the UK on May 6, according to theWHO. The infected person was returning from a trip to Nigeria.

On May 23, about 200 cases were reported outside of Africa; on May 30, more than 250 cases.

According to a tally by researchers at the Global.health group (New window)As of June 2, 2022, there were approximately 775 confirmed cases in nearly 30 countries and approximately one hundred suspected cases. No deaths have been reported.

The countries with the most confirmed cases are: England (199), Spain (156) and Portugal (138).

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Canada has about sixty cases, the vast majority in Quebec. In the province, the number of confirmed cases has more than doubled from 25 in less than a week.

At the moment, we speak of a probable case when a person has symptoms of the virus and has had contact with a confirmed or probable case or has traveled to an area where a confirmed case had been detected. People with no epidemiological link but who present the signs and symptoms associated with the disease are classified as suspected cases.

In Africa, 7 out of 54 African countries have reported the presence of the disease and there have been about three times as many cases of monkeypox as usual. According to the African Centers for Disease Control and Prevention, there have been more than 1,400 suspected cases and 63 deaths in Cameroon, Central African Republic, Congo and Nigeria. Fewer than 50 cases have been confirmed, as testing capabilities are limited in these countries.

Genetic sequencing did not show a direct link to the outbreak outside of Africa, according to health officials. Therefore, the current outbreak suggests that the virus has been spreading globally undetected for some time.

4. How is the virus spread?

The disease is usually transmitted from infected animals to humans, but can also be transmitted from humans. It can be spread during close physical contact with an infected person, their clothes, or their sheets.

However, some questions remain unanswered. For example, it is not known if infected but asymptomatic people can transmit the disease or if the disease could be transmitted through the air, as is the case with measles or COVID-19. Airborne transmission is thought to be less common, but not impossible.

Several of the cases involve men who have had sex with other men, but theWHO I would like to remind you that monkeypox is not considered a sexually transmitted disease. The disease is believed to be spread through close contact and not through sexual activity itself.

5. Can monkeypox be prevented?

The smallpox vaccine is also 85% effective against monkeypox, and the immunity conferred by vaccination appears to last for more than 25 years.

However, routine immunization programs ended in Canada and around the world in the early 1970s.

Large-scale vaccination campaigns are not recommended at this time. Several countries, including Canada and the UK, vaccinate certain high-risk people, including those who have had close contact with people suspected of being infected.

6. Why so many cases right now?

It is the first time that theWHO you see so many cases in so many countries at the same time, in other places than in Africa.

In 2003, an epidemic of monkeypox hit the United States. About 70 cases had been identified; none had led to a death.

Many scientists, however, are not surprised to see this explosion of cases around the world.

The number of monkeypox cases in Africa has been increasing for several years. (New window).

From 2005 to 2007, there were fewer than 800 cases in the DRC. More than 2,800 suspected cases were reported in 2018, then 3,800 in 2019.

In 2020, almost 6,300 cases were recorded, including 229 deaths. Cases were also rising in the neighboring countries of Sudan and the Republic of the Congo. In Nigeria, more than 500 cases have been recorded since 2017.

Researchers had also warned in 2010 (New window) that, because a large proportion of the population has never received the smallpox vaccine, the ape strain could spread beyond the Democratic Republic of the Congo.

Furthermore, the majority of cases in the Republic of the Congo in recent years are young people who have never been vaccinated against smallpox.

In addition, according to these same researchers, animal migrations caused by climate change and deforestation fuel human-animal interactions, facilitating the spread of viruses such as monkeypox to humans.

The high number of cases in Africa, combined with more travel since the lifting of restrictions related to the COVID-19 pandemic, may have created ideal conditions for its rapid spread.

According to’WHO, there is still no concrete evidence that the virus has mutated. It should be noted that these orthopoxviruses tend to be quite stable.