The virus now accounts for more than 643 cases of smallpox in dozens of non-endemic countries. Tedros Adhanom Gebreyus said on Wednesday.
In this study, genetic sequences showed that the first cases of monkey disease in 2022 were caused by an epidemic that occurred between 2017 and 2019 in Singapore, Israel, Nigeria and the United Kingdom.
Michael Sparrow, an evolutionary biologist and professor at the University of Arizona, who did not participate in the study, said that where the virus is endemic, “this epidemic has been going on at the local level for a long time.” He added that the world was unable to protect those in endemic areas with limited resources and could not control it at its source before it spread around the world.
“It’s actually a myth about two epidemics,” Sparrow said. “We really need to pay attention to where it’s spreading … and we need to take care of this population, just as we care about what’s happening in all the other countries around the world.”
If research shows that the virus is more prevalent among humans than previously thought, in other words, “a really good question,” according to Warrobe, why the world doesn’t think apes can be endemic. Outside of West and Central Africa?
“We don’t know how long this has been going on.”
Epidemiologist Anne Rimoin has been studying smallpox for more than two decades and has long warned that its spread in areas such as the Democratic Republic of the Congo could have far-reaching global health consequences.
The recent epidemic of smallpox is difficult to predict because we have not been able to fully study its origin.
“We don’t know how long this has been going on,” Rimoin said. “It can spread silently for a while.
“We have decided to watch a new series now, but we don’t know exactly which episode we are in. I mean, are we in the second episode or are we playing? the fourth episode or are we in the 10th series? And how many series are there in this series? We do not know”.
Previous cases of monkey smallpox have not been considered to be far removed from the initial effects of infected animals, usually rodents. Once the virus has spread among these animals, it can re-emerge in people who may be in contact with, for example, infected mares or guinea pigs.
If we continue to transmit the virus from person to person in this epidemic, even at low levels, it will lead to the possibility of re-spread of the infection. In an interview with CNN, Rimoin said that animals in non-endemic countries are “an existential threat to special opportunities.” This spread allows the virus to remain in the environment and, over time, to spread between animals and humans.
“We know enough about this virus, but we can’t know everything about this virus,” he said. “We need to study this very carefully.”
It is too early to tell
According to the World Health Organization, global health risks are moderate.
At a briefing last week, a spokesman for the U.S. Centers for Disease Control and Prevention said it was too early to say whether the virus could become endemic in the United States, but experts remained “hopeful” that it would not.
“I think we’re in the early days of our investigation,” the doctor said. Jennifer McQueiston, Deputy Director of the CDC’s Highly Dangerous Pathogens and Pathology Division.
“We hope we can cover that in the same way,” McQueen said.
According to the European Agency, “the probability of this spill is very low.”
“He was able to establish himself by being planted in mosquito populations and … bird populations,” Adalja said.
However, he agrees that monkeys are far from inevitable with smallpox because “2003 was a good opportunity for him to be” and it wasn’t.
According to Sparrow, there are too many unknown people to determine where the monkey smallpox is going.
“What we’re finding here in real time is that we know very little about what’s going on,” he said, “and I think it’s too early to convince the quilt.”
These are not just vague beginnings and silent spreads that are difficult to predict.
“It’s a completely different epidemiological landscape,” Rimoin added.
“What we know about monkeys is mostly from studies in very remote rural communities in Central Africa, where the dynamics of infection are very different,” he said, especially compared to “resource parameters in Europe or the United States.”
A World Health Organization official said Monday that a full-blown pandemic was not yet a cause for concern, but that did not mean some groups were not at risk.
“At the moment, we are not worried about a global pandemic,” said Rosamund Lewis, technical director for monkey disease at the World Health Organization’s Emergency Program.
However, “we are concerned that if people do not have the information they need to protect themselves, they may be at high risk of contracting this infection,” he said. “And because the global population has not been immune to orthopoxiruses since the end of smallpox eradication, we are concerned that the virus may try to take its place and spread easily among humans.”
“What we’re seeing now is starting in small groups, and then the investigation quickly led to the discovery of infections in a group of men who had sex with men … is the current epidemic,” Lewis said Tuesday.
“The main thing now is not to stigmatize,” he said.
A number of other questions may change the way we think about the transmission of the virus from person to person. For example, it is unknown how widespread the virus is when people have minimal symptoms or how mutations can affect the virus.
In this regard, Adlja said, there is no reason to worry.
First, the fact that doctors are seeing more cases of ulcers in the pelvic area than in more common areas, such as the face, arms, and legs, suggests that he may be in close contact with people with symptomatic skin lesions. Driven the spread, Adalja said.
Although it is important to eliminate all viral mutations seen in monkeys, this virus mutates relatively slowly because its genome consists of two strands of DNA, which are more stable than, say, single-stranded RNA of coronaviruses.
The rate of these mutations appears to have accelerated somewhat, Sparrow said of early research in Edinburgh. However, he added that the global epidemic may be due more to the virus’s access to new areas where it is easier to transmit, rather than to “relatively few mutations that have accumulated since 2017.”
“We don’t have an answer. We don’t really know,” Lewis said last week when asked if the virus was currently changing significantly.
“We don’t have any evidence that the virus itself has a mutation. We have started collecting this information,” he said. “We are inviting groups of virologists and other experts to discuss this issue based on the genomic sequence of some of the cases being identified.”
At the same time, health care workers around the world continue to monitor cases and their connections to better understand how the virus is spreading and how to stop it.
“Now,” Rimoin said, “we must do everything we can to stop the spread of the disease.”
CNN’s Arno Siad and Emmett Lions contributed to the report.