Unusual advance of monkeypox in humans: virologists seek explanation

The monkeypox virus normally only occurs in Central and West Africa. But now infections have been reported in Europe. So far there have been 23 cases in Spain, 5 in Portugal, 9 in the UK, 1 in Sweden and 1 in Italy.

What virologists are now trying to figure out is contagiousness. Because some cases are unrelated. Only one infection in Britain, reported on May 6, could be traced to a visit to Nigeria. The virus has also appeared in the United States. It is about a man who has been to Canada.

“It has been happening for some time that travelers import the virus,” Marion Koopmans, virologist at Erasmus MC, told RTL Nieuws. “In general, the spread is not very fast. In previous cases, the virus turned out not to be as efficient and the situation turned out to be quite easy to control. With the numbers we see now, something else seems to be going on. What is important is to find out what exactly happened. We need to look carefully at the situations in which the virus could be transmitted. Maybe there is something going on on the virus side itself, is it a bit more contagious. Fact finding is very important now.”

A spokesperson for the National Institute for Public Health and the Environment says that there are no known cases in the Netherlands so far. “But it is striking that it now seems that the virus seems to be more easily transmitted from person to person,” said the spokesperson.

Monkeypox virus sometimes deadly

Monkeypox starts just like the flu: you can suffer from fever, headache, nausea. But a few days later, patients are confronted with round blisters with pus, which dry out a few days later and finally disappear. Monkeypox and smallpox belong to the smallpox virus family, which is different from the well-known chickenpox that occurs in children.

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Monkeypox virus was first identified in monkeys in 1958, but today rodents are considered the main animal host. The vast majority of people recover from the illness within a few weeks. In a few cases hospitalization is necessary, and sometimes the disease can be fatal.

Two strains of the virus are known: the Congo strain is quite pathogenic and can even lead to death in 10 percent of cases. But there is also a West African strain that is less contagious and pathogenic, which can be fatal in about 1 percent of cases. “What we see in Great Britain is one of the milder varieties,” says Koopmans. “However, the virus is more dangerous for vulnerable people.”

According to experts, there is no reason to panic. “In general, the spread is not very fast, so we should not cause a whole hype,” says Koopmans. British professor Jimmy Whitworth also tells Reuters news agency that we are indeed seeing more cases than before. “But this isn’t going to cause a global epidemic like Covid-19. But we have to take it seriously because it’s quite a big outbreak that we need to get under control quickly.”

Sex between men

But experts also warn against more infections if cases are not discovered and reported. Travelers who are not aware of an infection can transmit the virus to other countries.

In general, infection occurs after very close contact, via respiratory drops. But the UK health service UKHSA now says a significant proportion of the infections were transmitted through sexual contact. In most cases, it involved sex between men. “An extremely unusual situation,” said a spokesman. The same sounds come from Spain: young men who contracted an infection after having sex with another man.

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Virologists are on the lookout because the monkeypox virus belongs to the smallpox virus, a serious infectious disease that has claimed many victims for centuries. But vaccination brought a solution. The world was declared “smallpox-free” in 1980; In the Netherlands, babies have not been vaccinated since 1974.

“The chance that the virus will spread from animal to human has increased as a result,” the virologist of Erasmus MC told RTL Nieuws. “There used to be herd immunity because of vaccination. That is slowly but surely disappearing, the elderly still have protection.”

In Britain they fight the virus by vaccinating the people around a patient with the smallpox vaccine.

Virologists are working with the World Health Organization to investigate the outbreaks, Koopmans says. “A lot of research is currently taking place, tests are being done and the information is being shared internationally.”

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