Status: 05/31/2022 12:19 p.m
Ordered vaccine doses, duration of isolation, containment: Much of the reporting on monkeypox is reminiscent of the corona pandemic. Where the two viral diseases differ – and where not. An overview.
the initial situation
The number of corona infections has been falling for weeks. The vaccinations, but also the dominance of the omicron variant, have taken away a large part of the horror of the virus after a good two and a half years. A seven-day incidence of around 200 is now reported, and most restrictions have now been lifted.
Now the previously little known monkeypox is causing new concern: so far 21 cases of monkeypox have been registered in Germany. The virus has probably been circulating unnoticed for a while. The first containment measures are taking effect, the first cases are being isolated – and yet the situation cannot be compared to the beginning of the corona pandemic.
Experts assume that the outbreak of monkeypox can be contained. The Robert Koch Institute (RKI) currently assesses the risk to the health of the general population in Germany as low. And even Health Minister Karl Lauterbach says: “I don’t think that monkeypox really poses a threat in the sense of a pandemic.” Lauterbach also assumes that the situation can be brought under control by tracing contacts and being careful.
“There is a huge difference between monkeypox and corona,” says virologist Norbert Nowotny from the Institute of Virology at the University of Veterinary Medicine Vienna: “This time it won’t be a pandemic. I assume that the spook will be over in a few weeks to a few months. ”
contagion and spread
Monkeypox is mainly transmitted from person to person through close physical contact, including via the contents of the blisters and scab. This severely limits its distribution. The fact that cases among homosexual men in particular are currently known could be related, among other things, to several international events at which infections occurred.
The RKI emphasizes that the risk is not limited to sexually active people or men who have sex with men. “Anyone who has close physical contact with an infectious person can become infected.”
Corona-infected people, on the other hand, pass on the SARS-CoV-2 virus mainly through virus-containing particles that arise when breathing, coughing and speaking, among other things. Aerosols with virus particles can remain in the air for a long time. One big difference: Since close contact is not necessary for infection, the virus can spread quickly.
So far, more than half a billion corona infections have been registered – many more are unlikely to have been discovered. According to estimates by the WHO, the corona pandemic cost the lives of around 14.9 million people worldwide in 2020 and 2021. The SARS-CoV-2 coronavirus has already established itself permanently in most countries around the world. The causative agent of monkeypox, on the other hand, is considered to be much more sluggish than SARS-CoV-2.
According to the RKI, the first symptoms of monkeypox are fever, headache, muscle and back pain and swollen lymph nodes. A few days after the onset of fever, skin lesions develop that eventually crust and fall off. In the typical smallpox lesions, the virus concentration is particularly high. The rash is usually concentrated on the face, palms, and soles of the feet, but can also affect the mouth and genitals. Serious courses and deaths are also possible.
With Corona, the most common symptoms are cough, fever, runny nose and loss of smell and taste. “The course of the disease varies greatly in terms of symptoms and severity, it can range from asymptomatic infections to severe pneumonia with lung failure and death,” says the RKI.
The mortality rate for the West African strain of monkeypox is one percent, says virologist Nowotny. Clemens Wendtner, chief physician of the infectiological clinic of the Schwabing hospital, restricts again. “You have to keep in mind, however, that these data from Africa cannot necessarily be transferred to the healthcare system in Europe or the USA, where mortality would tend to be lower,” he says. And he, too, reassures: “This is a disease that, in my opinion, does not have the potential to pose a massive threat to the population.” However, the mortality rate for the second, Central African variant is given as around ten percent.
A lower mortality rate is now expected at Omicron. “We currently have a mortality rate of less than 0.1 percent at Omikron, comparable to the flu,” said intensive care physician Stefan Kluge from the University Hospital Hamburg-Eppendorf of the Funke media group. However, it was significantly higher at the beginning of the corona pandemic, which can also be explained by the lack of vaccination and the original variant at the time.
medication and vaccination
A vaccine existed before monkeypox appeared in Europe. Although Imvanex has so far only been approved for human smallpox in this country, experts also assume that it is effective against monkeypox. Germany has ordered a total of 240,000 cans. Lauterbach expects the first 40,000 doses of vaccine in the first two weeks of June. With vaccinations in the area of known infection clusters, the outbreak could probably be significantly limited, says Ralf Bartenschlager from Heidelberg University Hospital. There is also a drug approved in the EU.
According to the WHO, vaccines used to eradicate smallpox show up to 85 percent effectiveness in controlling monkeypox. Some countries have already built up large stocks of smallpox vaccine. The US government says it has enough vaccine in its Strategic National Stockpile to vaccinate the entire population. However, the WHO assumes that mass vaccinations are not necessary.
There were initially no drugs or vaccines against the new coronavirus that emerged more than two years ago. That initially made containment more difficult. Several vaccines and various drugs are now available in Germany. In Germany, more than 75 percent of the population is vaccinated.
Monkeypox is actually a disease of rodents in West and Central Africa. Occasionally they spread to monkeys and also to humans, the latter has been known since 1970 according to the RKI.
The fact that the virus is spreading from person to person in Europe is new. The reasons for this are unclear. The corona virus SARS-CoV-2 was first discovered about two and a half years ago. It is believed that the first people were infected at an animal market in the Chinese city of Wuhan. A widely held theory is that the pathogen originally came from bats.
The monkeypox pathogen is a so-called DNA virus. The genome of these viruses is considered to be quite stable compared to RNA viruses such as the corona virus. This means: mutations occur less frequently. The West African variant has appeared in Europe and the USA. However, there is also a Central African variant.
The coronavirus, on the other hand, has evolved over the past two years. This made the virus much easier to transmit, and some vaccines were less effective. However, the variant Omikron, which is currently prevalent in Germany, usually leads to an easier course of the disease than earlier variants.