The latest monkeypox epidemic was declared a public health emergency of concern on July 23, 2022 by WHO Director-General Tedros Adhanom Ghebreyesus.
According to Dr. Tedros' official press statement, this decision stems from the current monkeypox epidemic, which has increased to more than 16,000 cases across 75 countries and territories, along with five fatalities.
I appreciate the decision of the WHO Director to declare the current global monkeypox epidemic a PHEIC, according to Dr. Boghuma K. Titanji, an assistant professor of medicine at Emory University. For several weeks now, the requirements for making monkeypox a PHEIC had been met.
I hope that this will boost the international emphasis on monkeypox and foster a more coordinated global response, which has unfortunately been lacking so far.
It is also an opportunity to improve on global health equity and access to technology, such as testing, vaccination, antiviral medications, etc., which are areas in which historically we have seen many shortcomings, resulting in countries with limited resources being left behind.
Dr. Boghuma K. Titanji
What is monkeypox?
Monkeypox is a zoonotic disease, which means it transfers from animals to humans. Various monkey species, giant-pouched rats, African dormice, and certain kinds of squirrels are among the animals that can carry monkeypox.
The Orthopoxvirus genus of viruses also includes smallpox. Because of this, symptoms are generally similar to those of smallpox, although they are not as severe.
During two outbreaks in monkeys in 1958, medical clinicians discovered the first monkeypox cases.
In 1970, researchers detected the first human presence of the disease in the Democratic Republic of the Congo. Since then, eleven African countries have reported monkeypox.
In 2003, the first monkeypox epidemic outside of Africa took place in the United States. Scientists linked it to prairie dogs infected with monkeypox.
How do people get infected?
monkeypox is a virus that has been translated from infected animals to humans. The transmission of the virus from an animal to a person is performed:
- being bitten or scratched by an infected animal
- eating meat or using products from an animal with monkeypox
- coming into contact with an infected animals body fluids.
Once a human becomes infected with monkeypox, they may transfer the virus to another person through:
- respiratory droplets during prolonged face-to-face contact
- intimate physical contact, including kissing and sexual intercourse
- directly touching the infectious rash or body fluids of an infected person
- touching clothing, bedding, and other materials that have been in contact with an infected persons rash or body fluids.
Because monkeypox is spread between humans through close contact, the Centers for Disease Control (CDC) provides guidelines for individuals who are sexually active in order to prevent being sexually active.
A recent publication in the New England Journal of Medicine found that between April and June 2022, 98 percent of persons with a monkeypox infection were gay or bisexual men, and 95 percent of monkeypox cases were caused by sexual transmission.
Is monkeypox actually a sexually transmitted disease (STD)?
According to Prof. Piero Olliaro, the director of clinical research at the Epidemic Diseases Research Group Oxford (ERGO) and the International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC), not so.
Il emphasized that it is important to remember that monkeypox is transmitted on the occasion of close contact by a variety of means. That includes sexual intercourse, but that is not the only way of transmission.
Although the virus does not only circulate through intercourse, it may also transmit through respiratory drops, which may mean that it may more easily transmit between individuals from close-knit communities, such as LGBTQIA+ communities.
The fact that the actual epidemic in non-endemic countries is yet to essentially involve men who have sex with them means that the involvement and buy-in of the LGBTQ+ community is imperative, according to Prof. Olliaro.
He said the technique has proven to be effective in other similar situations, allowing him to identify what would work, and to make it happen to break the transmission chains.
What are monkeypox's symptoms?
When a person discovers monkeypox, the incubation period before they begin to show symptoms lasts anywhere from 5 to 21 days.
The majority of individuals experience two sets of monkeypox symptoms. The first symptoms are usually observed for about five days, including:
- headaches and/ or back pain
- swollen lymph nodes
- muscle aches
- low energy.
A few days after having a fever, a rash usually occurs on the person infected with monkeypox. The rash looks similar to pimples or blisters and may be seen on many areas of the body, including:
- palms of the hands
- soles of the feet
- inside the mouth
- genitals and/ or anus.
The symptoms usually last between two and four weeks. Monkeypox currently has a fatality rate of 3% to 6%.
What is monkeypox treated?
The medical system for diseases generally includes medications to treat certain symptoms.
TPOXX is a nonviral medication developed by SIGA Technologies for the treatment of smallpox and related diseases. According to Dr. Dennis Hruby, TPOXX is the only approved antiviral for the treatment of monkeypox.
The European Medicines Agency (EMA) and the Medicines and Healthcare Products Regulatory Agency (MHRA) in the United Kingdom are among the public health agencies that have yet approved TPOXX for the treatment of monkeypox infection.
The Food and Drug Administration (FDA) has approved Tecovirimat for the treatment of smallpox, although it is not currently monkeypox.
For this reason, the CDC maintains a non-research expanded access Investigational New Drug (EA-IND) protocol that permits clinicians to use tecovirimat to treat all orthopoxvirus infections, including monkeypox, in both children and adults.
The US has 1.7 million courses of TPOXX in the strategic national stockpile, according to Dr. Hruby. It is distributed by the CDC under an EA-IND for the treatment of monkeypox. SIGA has donated small quantities of tecovirimat to the United Kingdom for use in the most severe cases.
How can people stay safe?
monkeypox is currently being tested with two vaccinations.
The FDA has approved the JYNNEOS vaccination known as Imvanex for preventing smallpox and monkeypox in persons aged 18 to older. In early July, the US Health and Human Services announced the purchase of 2.5 million additional doses of the JYNNEOS vaccination.
In order to increase the vaccine supply for monkeypox individuals under 18 years old, the FDA issued an emergency use authorization (EUA) for JYNNEOS. If JYNNEOS is at high risk of infection, the EUA extends the delivery of the JYNNEOS vaccine to people under 18 years old.
Imvanex is a technique used by the EMA to help prevent monkeypox in adults.
The JYNNEOS vaccine involves two injections, with individuals being considered fully vaccinated about two weeks after the second.
ACAM2000, the second vaccine, has been approved in order to prevent smallpox in the United States, and has an expanded IND for monkeypox.
The ACAM2000 vaccine provides only one dose and involves a potential vaccinated person about four weeks after. Additionally, clinicians advise certain individuals do not receive the ACAM2000 vaccination, including:
- pregnant individuals
- infants under 1 year of age
- people with very weak immune systems
- those with cardiac disease
- people living with HIV and other immune deficiency disorders
- those living with atopic dermatitis/ eczema.
Meme if immunization is necessary, Prof. Olliaro argued that it may not be the complete solution.
Vaccination alone may not work unless backed by other measures, such as capacity to diagnose and treat early, according to the president.
People should take the following steps to help prevent the spread of monkeypox, according to medical professionals:
- avoid intimate and skin-to-skin contact with a person who has a rash similar to that of monkeypox
- try not to touch bedding, clothing, or other materials that may have touched a person with monkeypox
- wash hands frequently with soap and water
- in certain African regions, keep away from known animal carriers of monkeypox, and do not touch sick or dead animals.