It may be too late to stop monkeypox becoming endemic in America and Europe

We failed to defeat the monkeypox epidemic and missed an opportunity to stop the disease from becoming an endemic and persistent threat in the US and Europe.

Monkeypox is spreading rapidly throughout the world, especially in the United States and Europe. With the number doubling every two weeks, monkeypox threatens to become a persistent problem in countries where it was once rare and small.

Smallpox, in other words, tends to become endemic in many new areas. If so, it can be very difficult to remove. Monkeypox becomes another disease that causes fever and rashes and in very rare cases is fatal.

There are two ways of endemism for smallpox. If the virus infects people quickly enough to outpace efforts by authorities to detect the disease and vaccinate those at risk, it can become endemic in humans. “We’re getting close to it,” James Lawler, an infectious disease expert at the University of Nebraska Medical Center, told the Daily Beast.

The good news about such endemism is that it is not there is I am persistent. Eradicating human endemism is difficult, yes, but it is possible. Amesh Adalja, a public health expert at the Johns Hopkins Health Center, told the Daily Beast: “If it spreads in humans, it can be controlled through vaccination and natural immunity.”

But monkeypox was originally a “zoonotic” animal virus. It is prevalent in rodent and monkey species in West and Central Africa, where outbreaks in human populations are common.

If smallpox finds a home in certain animal species in North America or Europe (such as squirrels, rats, or prairie dogs), it cannot be eradicated regionally. “Game over,” Lawler said. Smallpox is around us, perhaps forever, waiting for opportunities to spread from animals to humans. Epidemics like those currently occurring in West and Central Africa are frequent and large.

To be clear, smallpox is not endemic in humans or animals in the United States or Europe. But the trends are not encouraging. “I share the concern of other scientists about the virus persisting and becoming endemic in the US rodent population,” Stephanie James, head of the Viral Testing Laboratory at Regis University in Colorado, told The Daily Beast.

Officials first became aware of the current outbreak, which involves a relatively mild form of West African smallpox, after diagnosing it in a British traveler returning from Nigeria in early May. Spread through close physical contact, including sexual intercourse, smallpox recently accompanied travelers flying to distant lands. Doctors diagnosed the first disease in the United States on May 27.

But now it is clear that it is the first diagnosed Smallpox in Europe and the United States were not the first real cases. On June 3, the US Centers for Disease Control and Prevention announced that it had found genetic evidence of the first American case of smallpox in Europe since May.

The rapid spread of monkeypox among humans is a preventable tragedy. But it could get much worse.

Because the symptoms of chickenpox are similar to those of some sexually transmitted diseases, such as herpes, doctors may not notice or report these infections at first. “The virus was disguised as a sexually transmitted infection and spread secretly for months,” Adalja explained.

The virus had a big start, which helps explain why, months later, it’s still ahead of ramping up efforts to contain it. As of Wednesday, there were 20,638 confirmed cases in 77 countries, according to the CDC. That’s up from less than 10,000 cases two weeks ago. The World Health Organization has counted five smallpox-related deaths in non-endemic countries.

What frustrated epidemiologists was that, in theory, we had all the tools to catch smallpox quickly. Thanks to COVID, healthcare workers around the world are better than ever at tracing contacts. Vaccines and therapies that work against smallpox can also help with monkeypox. There is a proven strategy: identify the disease, isolate and treat the infected, and vaccinate their family, friends, and colleagues.

Educate the public, especially at-risk groups, including men who have sex with men.

But so far the strategy is not working. Part of the problem is the virus itself, Lawler said. “The disease is different from the monkeypox we have seen before. I don’t think we know the cause—probably a combination of the virus, the hosts, and the environment.”

Often it is our own fault. Too many doctors misdiagnose chickenpox as herpes or another STD. Both the WHO and the CDC took a long time to designate smallpox as a public health emergency and mobilize resources. The World Health Organization declared a state of emergency on July 23. The CDC is expected to do the same in the next few days.

Authorities are ramping up testing, deploying more vaccines and therapies. Nevertheless, clinicians on the front lines of public health in the United States need more of all. More tests. More vaccines and therapies. More money for the community. The US National Coalition of STD Directors recently surveyed 100 clinics and found that half of them do not have the capacity to deal with monkeypox.

“We’re still going very slowly,” Lawler warned. And, he added, “we’re still ruling out the possibility of the unexpected.” In it, the possibility of smallpox spreading to mice or rats increases.

The feds seem to have failed to deal with “reverse zoonotic” human-to-animal transmission. To prevent endemicity in animals, you must detect smallpox infection in a species, cull infected animals, and then closely monitor the remaining population to make sure you have eliminated all the virus.

But it’s not clear who should take the lead at the federal health agency. “The operational zoonotic disease response falls into this gray area,” Lawler said. The CDC maintains a website that describes the symptoms of po in pets and livestock and explains where to send samples for diagnosis. The Animal and Plant Health Control Service of the Department of Agriculture controls animal diseases. Especially animal husbandry.

APHIS could not or would not confirm that it tests animals for monkeypox. The agency did not respond to an email seeking comment, referring The Daily Beast to the CDC. If there is a lead agency for detecting animal pox, that agency doesn’t seem to want to take responsibility.

The rapid spread of monkeypox among humans is a preventable tragedy. But he can still get it lot of bad With hard work and a little luck, human disease can still be contained and eventually eradicated.

But if American or European rodents catch smallpox, the epidemic turns into something much worse. A new endemic disease. It cannot be destroyed.

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