The current monkey pox virus may show an accelerated evolution as new cases increase

Monkey disease, first reported by health authorities in Europe in May, is on the rise. According to a recent report by the World Health Organization, there are more than 2,100 confirmed cases and at least one death.

Geneticists now have enough information to understand exactly how the epidemic began and where it is going.

This is not good news. Monkeys are endemic in Africa, a viral disease that causes smallpox, fever and rashes and can cause a small percentage of deaths. But now it is operating freely on all continents and is developing rapidly. Healthcare professionals have all the tools that it contains, first and foremost, search for contacts and vaccines – now the virus is moving faster and adapting faster than us.

The current strain of monkey smallpox is circulating, unknown, months The first case outside of Africa is before we finally make a diagnosis. Because there are more copies of the virus than we expected, and each of them mutates individually, this new strain of smallpox can develop into dangerous new forms at an alarming rate.

“Our data reveal additional signs of ongoing viral evolution and potential human adaptation,” said a team led by Joana Isidro, a geneticist at the National Institutes of Health, Dr. Ricardo Jorge of Spain wrote in a new peer-reviewed study published on Friday Nature Medicine.

A medical laboratory assistant prepares to test for suspected smallpox in the microbiology laboratory at La Paz Hospital.

Pablo Blazkes Dominguez / Getty

Smallpox first broke out in the Democratic Republic of the Congo in 1970 from apes or rodents to humans, and has been rampant in Africa for decades. There are two main strains in West and Central Africa. Mild West Africa can cause up to 1 percent of deaths. A dangerous strain in Central Africa could kill 10 percent of those infected.

Smallpox is most often transmitted through close physical contact, especially sexual contact. it is but not a sexually transmitted disease. It simply uses skin-to-skin contact that accompanies sex. The virus can travel short distances with saliva, but does not meet the “airborne” requirement.

Smallpox sometimes spreads to non-endemic areas. In 2003, 47 people in the United States became infected with West African strains after being bitten by rodents from Ghana to Texas. The rapid response of state and federal health officials and several doses of the smallpox vaccine, which worked against monkeys, temporarily killed the virus in the United States, preventing anyone from dying.

Because there are more copies of the virus than we expected, and each one mutates individually, this new strain of smallpox can develop into dangerous new forms at an alarming rate.

Officials first noticed the current state of the West African strain after diagnosing a British traveler returning from Nigeria in early May. During a trip to Europe, the virus spread rapidly through physical contact. David Heymann, a former head of the World Health Organization’s emergency department, said men on flights to Spain and Belgium had “exacerbated” the epidemic through close contact with other men, sometimes through sexual contact.

The virus then accompanied travelers on flights to distant lands. Doctors diagnosed the first case in the United States on May 27. As of Thursday, the U.S. Centers for Disease Control reported about 3,500 cases in 44 countries, including 172 in the United States.

Only one person has died of smallpox in the current epidemic in Nigeria. However, serious illness and death can delay the true diagnosis by several weeks, so many more deaths can occur.

Worse, on June 3, the CDC announced that it had found genetic evidence of smallpox in the United States for the first time in Europe since May. Because of the similarities between the symptoms of smallpox and some sexually transmitted diseases, such as herpes, doctors may not have noticed or reported these cases at first.

There have been speculations that previous U.S. incidents were part of a completely separate epidemic that coincided with the May epidemic. Isidro and his team sorted 15 samples from current smallpox patients and concluded that there was only one major epidemic. “All epidemic MPX strains are consistently concentrated close to each other, indicating that there is an origin of the ongoing epidemic,” they wrote, using a scientific acronym for monkey smallpox.

A passenger walks past Soekarno Hatta International Airport in Tangerang, near Jakarta, Indonesia, amid reports of a smallpox virus.

Jepayona Delita / Getty

This is not very clear when are The current epidemic has really begun. According to Isidro and the company, the virus may have spread beyond endemic countries before officials noticed the infections and rang the bell. The geneticists wrote that the virus spread to animals outside Africa, such as domestic rodents, and eventually jumped on human owners, spreading from animal to animal until May, when the current epidemic broke out.

Apparently, monkey pox spread from person to person, and recently Isidro’s team came to the conclusion. “Current data suggest a scenario of more than one introduction coming from one place, a super-spider event (s) (e.g., saunas used for sexual encounters) and travel could lead to a rapid spread around the world.”

In other words, one or more people came in contact with an infected person in Africa and then flew to Europe or the United States to spread the virus to other people through direct contact. “Single Origin” is the infected human population in Africa. “More than one introduction” means that several travelers take the same smallpox strain and spread it simultaneously outside Africa.

All of this. The May incident in the UK was first noticed by the authorities, but it is not the infection that started the epidemic.

When you start looking for something, you find it.

Michael Wiley, University of Nebraska Medical Center

One of the most dangerous possibilities is smallpox, which is common or common It is prevalent in non-endemic countries to some extent, but we rarely notice that a large increase in infections forces doctors to carefully consider symptoms that can be easily mistaken for something else. Say, herpes. “When you start looking for something, you find it,” said Michael Wiley, a public health expert at the University of Nebraska Medical Center who did not participate in the new study.

In any case, unnoticed or recurrent vectors of infection are a cause for concern, and while they do not mean that the virus can spread faster, authorities may eventually contain an epidemic. No, multiple interventions can also allow the virus to mutate more or faster than usual.

When it comes to viral diseases, each infected person is a separate living laboratory – a place where the virus interacts with the antibodies and T cells of the human immune system and develops measures against it. The more individual chains of smallpox, the higher the chance that the virus will mutate in some way on these vectors. benefits he and It hurts For example, we develop resistance to our vaccines and antibodies.

Isidro’s team found a single nucleotide polymorphism, or SNPs, in 50 of the monkey smallpox strains behind the current epidemic. Each SNP is a change in the basic DNA of a particular organism. Fifty SNP “much more than one would expect (about 6-12 times more)” geneticists wrote. “Such a differentiated branch may reflect accelerated evolution.”

This does not mean that smallpox itself is learning to grow faster. It is possible that the current epidemic has reached some genetically critical mass before we intervened. People who are more infected have a greater chance of evolution, even if the individual rates of mutation are the same.

“If I have to guess, I think we might see more drift in the number of mutations depending on the size of the epidemic,” said James Lawler, an infectious disease specialist and Wiley colleague at the University of Nebraska Medical Center, told The Daily Beast. “Drift” is just a nice term for “reproduction” in this context.

The monkey smallpox may have been hiding invisibly until we noticed it two months ago. It is possible that this strain of the virus was successful, and several travelers helped spread it outside Africa at the same time. Probably because he is developing faster because he is getting smarter. Apparently, it is changing in the current fast clip, because there are more copies of the virus than we expected, each of which is mutated.

All of this is bad news – and it should create an even more urgent feeling among health care workers as they try to diagnose and cover the number of illnesses.


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