【Creative Cultivation Program】Why is monkeypox listed as a “Public Health Emergency of International Concern”?

Author: Chen Wen

Reviewer: Jie Zhijun, Chief Physician, Shanghai Fifth People's Hospital Affiliated to Fudan University

2022 is destined to be an uneasy year - there were recurring COVID-19 outbreaks before, and now there is the monkeypox outbreak, leaving everyone at a loss for a while.

According to Xinhua News Agency, World Health Organization Director-General Tedros Adhanom Ghebreyesus announced on the 23rd that the monkeypox epidemic currently spreading in 75 countries and regions has constituted an "international public health emergency." This is the highest level of alert issued by the organization for global public health emergencies, which also means that the current COVID-19 epidemic and monkeypox epidemic are at this alert level at the same time.

So, what exactly is monkeypox?

Monkeypox is a viral zoonosis caused by the monkeypox virus. It can be transmitted between humans and animals, and can also be transmitted secondary to humans. The virus was first discovered in 1958 in a population of monkeys used for research, hence the name monkeypox. The first human case of monkeypox was discovered in 1958. Monkeypox is common in Congo, Central Africa, and West Africa.

Symptoms of monkeypox in humans are similar to those of smallpox. Symptoms usually last 14 to 21 days. Early on, patients experience fever, severe headache, swollen lymph nodes, back pain, muscle pain, and fatigue (lack of energy). As the disease progresses, the number of lesions increases from a few to thousands, gradually affecting the patient's oral mucosa, genitals, conjunctiva (eyelids), and cornea (eyeball).

However, the two are not exactly the same. First, monkeypox is far less contagious than smallpox. Second, in terms of symptoms, patients infected with monkeypox may develop severe lymphadenopathy, but patients infected with smallpox or chickenpox do not have this characteristic. Therefore, this characteristic has become an important way to distinguish the two viruses. Finally, we have found a way to deal with smallpox, but we are still helpless against monkeypox.

Currently, there is no specific treatment for monkeypox. The only thing to do is to isolate the patient as much as possible to prevent skin damage and secondary infection. However, monkeypox is not an incurable disease. As a self-limiting disease, it means that it does not require treatment and the patient will generally recover within 2 to 4 weeks after the onset of the disease.

At first glance, monkeypox doesn't seem to be very effective, but why was it identified as an "international public health emergency" this time?

First, the scope of this monkeypox outbreak is wider than before, and it has spread rapidly to many countries where cases have never occurred before. So far, 75 countries and regions around the world have reported more than 16,000 cases to the WHO, including 5 deaths. This has never happened before. Most of the previous cases were distributed in African countries such as the Democratic Republic of the Congo, the Republic of the Congo, the Central African Republic, Nigeria, and Cameroon.

Secondly, this monkeypox outbreak has met the criteria for declaring a "public health emergency of international concern" as stipulated in the International Health Regulations - the current incident is serious and sudden; the impact on public health goes beyond the borders of the affected country; and immediate international action may be required.

Third, we still don’t have enough scientific information, evidence, and other information about monkeypox. Although it’s too late to prevent it now, it’s still necessary to be vigilant.

Finally, the current international spread of monkeypox is bound to have an impact on our lives, such as international flights, cargo transportation, etc.

Although the situation is serious, we don't need to worry too much.

According to the WHO's assessment, only Europe is currently at high risk of monkeypox, and the risk in other regions is still moderate. According to the WHO, observational studies have shown that smallpox vaccination is about 85% effective in preventing monkeypox, and previous smallpox vaccination may reduce the severity of monkeypox virus infection. We also produce a certain number of "Tiantan" smallpox vaccines each year as reserves.

In terms of prevention, common disinfectants in our homes can kill the monkeypox virus. At the same time, we should avoid contact with animals that may carry the virus. If you come into contact with infected people or animals, you should wash your hands with soap and water or use alcohol-based hand sanitizer. It is also recommended to wear protective equipment when caring for patients. Finally, we should not eat wild game or travel to areas where monkeypox virus infection occurs for the sake of momentary pleasure.

Although the current situation is still tense and there are even various unimaginable difficulties, these difficulties are not unsolvable. We still need to keep a calm mind and take good precautions.

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This article is produced by the Science Popularization China-Creation Cultivation Program. Please indicate the source when reprinting