There are still plenty of uncertainties, but what do we know about monkey pox?

What is going on?

Cases of the monkeypox virus are suddenly appearing in many countries. It is a virus that mainly circulates in Africa and until now it has only occurred very sporadically on other continents. “Until now, it didn’t seem like a very contagious virus,” says Jaap van Dissel of the RIVM. |In recent years, an occasional case has surfaced, usually in England, where many people with Nigerian roots live. The infected person had then been to Africa and infected only a few family members at the most.

Now something else is going on: Of the cases, almost none have been to Africa or have been in close contact with anyone who has.

Who has contracted the virus now?

Cases have surfaced this week in the Netherlands, Belgium, Germany, France, Great Britain, Spain, Portugal, Italy, Sweden, the United States, Canada and Australia. Most infections occurred among men who have sex with men. That suggests that the virus is also sexually transmitted, which it wasn’t until now.

What kind of virus is it?

The monkeypox virus is closely related to the life-threatening smallpox virus, which has been completely eradicated from all over the world for decades. In general, someone infected with monkeypox will first develop flu-like symptoms, followed by blisters all over the body that are very reminiscent of chickenpox. They go away after two weeks. “We are dealing with a well-known branch of the virus, the West African variant,” says Van Dissel.

This variant is known as mild, but so is the virus as we knew it until now. Some of the people who have contracted the virus now have a different course of disease. For example, we see a group that does not get these blisters all over the body, but especially around the anus. Van Dissel: “We are now investigating whether there is another mutation, because that can also entail other risks. We just don’t know that yet.”

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How can you get it?

Until now, it seemed that the virus was not very contagious. Only very close contacts of an infected person, such as family members, sometimes became infected. This was done by breathing in tiny flakes from the blisters, which, for example, ended up in the air when the bedding was shaken, explains Van Dissel. “Now it seems that it can also be spread through intensive physical contact.”

Is there cause for panic?

We don’t know yet, but it doesn’t look like it for now. Even though the disease progresses differently this time than we know, relatively mild complaints are still being reported, says Van Dissel. “In any case, technically this is a very different kind of virus than the coronavirus. This is a so-called DNA virus, they have much less tendency to mutate, they are much more stable.”

Should we be prepared for a pandemic?

“That seems very unlikely to me,” says Van Dissel. “But at the same time: it’s a remarkable picture that we see now. We still have a lot to learn about this virus.”

What can we do?

Dutch people born before 1974 are probably protected against the virus because they received a smallpox vaccine. After that we stopped vaccinating against smallpox, because the disease was eradicated and the smallpox vaccination was a relatively risky vaccination.

If necessary, the Netherlands has a stock of modern smallpox vaccines, with far fewer risks available. If necessary, in the event of an infection, the immediate environment could be vaccinated.

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