The monkeypox epidemic clearly does not constitute the world's highest public health event, so why is there still a risk of it getting out of control?

According to U.S. media reports on July 3 local time, U.S. infectious disease experts and public health advocates warned that the Biden administration's response to the monkeypox outbreak was too slow and the United States was at risk of losing control of the disease. Earlier, the World Health Organization (WHO) held an emergency committee meeting, and the committee members unanimously agreed that the monkeypox outbreak does not constitute a "public health emergency of international concern" at this stage. So what are the characteristics of the monkeypox outbreak that make it not the world's highest health event, but also require our vigilance and control?

1. What is monkeypox?

Monkeypox is a very rare zoonosis (most infectious diseases in humans originate from animals). The pathogen that causes monkeypox is a DNA virus called monkeypox virus, which belongs to the genus Orthopoxvirus. You may not be familiar with the monkeypox virus in the genus Orthopoxvirus, but it has a relative with a well-known name, smallpox.

Smallpox virus is one of the oldest and most lethal viruses in history (the first recorded case of smallpox in history was by the ancient Egyptian pharaoh Ramses V in 1145 BC), and it has killed hundreds of millions of people. However, with the invention and popularization of smallpox vaccine, the World Health Organization announced in 1980 that smallpox had been eradicated worldwide.

Monkeypox virus belongs to the genus Orthopoxvirus and is a DNA virus

Monkeypox was discovered nearly 3,000 years later than smallpox. In 1958, scientists first discovered and identified the monkeypox virus in a group of experimental monkeys. In 1970, humans in the Democratic Republic of the Congo in Central Africa were infected with the monkeypox virus for the first time, and it spread to a certain extent in some rural areas of the Congo Basin and West Africa. Since then, many African countries have also experienced intermittent monkeypox outbreaks. Monkeypox is not unfamiliar to African countries, but it is an extremely rare disease in Asian and European countries, especially developed countries. Therefore, the outbreak of monkeypox in European and American countries has attracted close attention from the World Health Organization.

2. Common symptoms of monkeypox

The symptoms of monkeypox and smallpox are similar, with rash on the skin of infected people being a characteristic manifestation. The incubation period of monkeypox varies from 5 to 21 days. In the early stages of infection, patients will experience fever, general discomfort, fatigue, headache, myalgia, back pain, sore throat, etc. (similar to influenza, almost all viral infections have similar symptoms, which are not characteristic). As the disease progresses, signs such as rash and swollen lymph nodes may appear. Severe cases may develop sepsis, pneumonia, encephalitis, etc.

Monkeypox patients have flu-like symptoms in the early stages, followed by a rash that breaks out.

Although the symptoms of monkeypox are much milder than its relative smallpox and the mortality rate is much lower than smallpox, according to past statistics, monkeypox still has a mortality rate of 1%-10%.

3. The main transmission routes of monkeypox

Monkeypox is mainly transmitted to humans by primates or rodents. People are infected after direct contact with animals carrying the monkeypox virus or being bitten by them. Monkeypox virus is not easily transmitted between people. It is mainly transmitted from person to person through close contact with secretions or contaminants from broken skin of infected people (such as clothing, bed sheets, towels, etc. used by patients), or long-term face-to-face contact with patients, and infection through respiratory droplets.

In 2003, there was an outbreak of monkeypox in the United States. Texas imported more than 800 mammals from Ghana, causing the monkeypox virus to spread to many states in the United States.

Wildlife trade was responsible for the 2003 U.S. monkeypox outbreak

How to prevent monkeypox

The key to preventing infectious diseases is to control the source of infection, cut off the route of infection and protect susceptible populations. From the above introduction, we know that the main source of infection for monkeypox is wild animals. Researchers, hunters and pet store staff who often come into contact with animals are common infected people. Therefore, not buying or eating wild animals, especially not buying some strange animals from abroad online, is the key to preventing the disease. In addition, do not share clothes and towels with others.

Smallpox vaccination is an effective way to prevent monkeypox, so if you are traveling to Central or West Africa or a country with a recent monkeypox outbreak, smallpox vaccination is the most effective means of prevention.

Smallpox vaccine effectively protects against monkeypox

5. Will monkeypox become a pandemic?

The three-year pandemic of the novel coronavirus has made everyone highly sensitive, and they are all worried about whether this infectious disease will cause a global pandemic. According to current data analysis, the possibility of a pandemic is relatively low, mainly for the following reasons:

First, the transmission ability of monkeypox virus is far weaker than that of the new coronavirus. From current observations and studies, monkeypox virus is more commonly transmitted from animals to humans, but it is difficult for humans to transmit from one person to another, so it is difficult to spread rapidly and on a large scale among the population.

Second, monkeypox virus is a DNA virus. Compared with RNA viruses (the new coronavirus is an RNA virus), it has a lower mutation rate and is not easy to mutate.

Third, we already have a mature vaccine. The smallpox vaccine can effectively prevent monkeypox, and the preparation of smallpox vaccine is a mature technology that does not require temporary research and development.

Fourth, the mortality rate of monkeypox is much higher than that of COVID-19. The mortality rate of monkeypox is 1%-10%, which is completely different from that of COVID-19. Therefore, in theory, European and American countries cannot just sit back and do nothing like they did with COVID-19, and should still actively prevent and treat it.

Fifth, the symptoms of monkeypox are even more unacceptable than those of COVID-19. Blisters and ulcers appear all over the body. Many people find it difficult not to see a doctor when they see these symptoms. This helps to detect infected people early and reduces the difficulty of prevention and treatment.

In addition, due to the prevention and control of the new coronavirus, my country's customs has strengthened the quarantine of foreign animals and strictly isolated foreign personnel for epidemic prevention, which also helps prevent the disease from being imported into my country. Therefore, the probability of this disease causing a global pandemic should be very low, and there is no need to panic.