The spread of monkeypox in Europe and the United States baffles African scientists | News

As more cases of monkeypox are detected in Europe and North America, some scientists who have monitored numerous outbreaks in Africa say they are baffled by the unusual spread of the disease in developed countries.

Cases of the smallpox-related disease have never been seen in people with no connection to West and Central Africa.

France, Germany, Belgium and Australia confirmed their first cases of monkeypox on Friday.

Over the past week, the UK, Spain, Portugal, Italy, the US, Sweden and Canada have all reported infections, mostly among young men who have never traveled in Africa before.

“I am amazed by this,” said Oyewale Tomori, a virologist who previously headed the Nigerian Academy of Sciences and sits on several World Health Organization (WHO) advisory boards.

“Every day I wake up and there are more countries infected,” Tomori said.

“This is not the kind of spread we have seen in West Africa, so there may be something new happening in the West,” he said.

Monkeypox usually causes fever, chills, rash, and lesions on the face or genitals. The WHO estimates that the disease is fatal for around one in 10 people, but smallpox vaccines are protective and some antiviral drugs are also in development.

One of the theories British health officials are exploring is whether the disease is sexually transmitted. Health officials asked doctors and nurses to be on alert for potential cases, but said the risk to the general population was low.

Outbreaks in Nigeria, which reports about 3,000 cases of monkeypox a year, typically occur in rural areas, where people come into close contact with infected rats and squirrels, according to Tomori. He said the disease does not spread very easily and many cases are likely to be missed.

“Unless the person ends up in an advanced health center, they don’t get the attention of the surveillance system,” he said.

Tomori hoped that the appearance of monkeypox cases across Europe and other countries would promote scientific understanding of the disease.

The European head of the WHO said he fears monkeypox could spread as people gather for parties and festivals over the summer months.

“As we enter the summer season in the European region, with mass gatherings, festivals and celebrations, I am concerned that transmission will accelerate as the cases currently detected are among those engaging in a sexual activity, and the symptoms are unfamiliar to many,” WHO Regional Director for Europe Hans Kluge said on Friday.

A section of skin tissue, harvested from a lesion on the skin of a monkey, which had been infected with the monkeypox virus
A section of skin tissue, harvested from a lesion on the skin of a monkey, which had been infected with the monkeypox virus [CDC/Handout via REUTERS]

“So many unknowns”

WHO Emergency Response Manager Dr Ibrahima Soce Fall acknowledged this week that there are still “so many unknowns in terms of transmission dynamics, clinical characteristics (and) epidemiology”.

The UK Health Security Agency reported 11 new cases of monkeypox on Friday, saying a “notable proportion” of the most recent infections in the UK and Europe have been in young men with no travel history to Africa who were gay, bisexual or had sex with men. Authorities in Spain and Portugal also said their cases involved young men who mostly had sex with other men and said the cases were detected when the men presented with lesions to clinics. sexual health.

Experts have stressed that they do not know whether the disease is spread through sex or through other close sex-related contacts.

“It’s not something we’ve seen in Nigeria,” said virologist Tomori.

He said viruses that were not initially known to be sexually transmitted, such as Ebola, were later found to do so after larger outbreaks showed different patterns of spread. The same could be true for monkeypox, Tomori said.

“We should review our records to see if it could have happened, like between husband and wife,” he said.

In Germany, Health Minister Karl Lauterbach said the government was confident the outbreak could be contained. He said the virus was being sequenced to see if there were any genetic changes that could have made it more infectious.

Rolf Gustafson, a professor of infectious diseases, told Swedish broadcaster SVT it was “very difficult” to imagine the situation could get worse.

“We will definitely find more cases in Sweden, but I don’t think there will be an outbreak in any way. There is no indication of that at the moment.”

The palms of a monkeypox patient from Lodja, a town in the Katako-Kombe health zone,
The palms of a monkeypox patient in the Democratic Republic of the Congo in 1997 [File: Brian W.J. Mahy/Reuters]

“We really need to understand why”

Scientists have said that while it is possible that the first patient in the outbreak caught the disease in Africa, what is happening now is exceptional.

“We have never seen anything like this happening in Europe,” said Christian Happi, director of the African Center of Excellence for Genomics of Infectious Diseases.

“We haven’t seen anything to indicate monkeypox transmission patterns have changed in Africa, so if something different is happening in Europe, then Europe needs to investigate that.”

Happi also pointed out that the suspension of smallpox vaccination campaigns after the disease was eradicated in 1980 could inadvertently contribute to the spread of monkeypox. Smallpox vaccines also protect against monkeypox, but mass vaccination was stopped decades ago.

“Apart from people in West and Central Africa who may have some immunity to monkeypox from past exposure, lack of smallpox vaccination means no one has any sort of immunity. against monkeypox,” Happi said.

Shabir Mahdi, professor of vaccinology at the University of the Witwatersrand in Johannesburg, said a detailed investigation of the outbreak in Europe, including determining who the first patients were, was now essential.

“We really need to understand how it started and why the virus is now gaining traction,” he said.

“In Africa, there have been very controlled and infrequent outbreaks of monkeypox. If this is changing, we really need to understand why.

Leave a Reply