First modification:
It is inevitable to ask the question, especially after two years of emergency due to the Covid-19 pandemic. A new outbreak of another disease is now added to the list of health crises, but that does not mean that monkeypox can reach the magnitude that the coronavirus had and has.
It will not be a new pandemic, but it is definitely an outbreak that requires our attention: monkeypox was declared a “public health emergency of international importance” by the World Health Organization (WHO) last Saturday, July 23.
There are already more than 16,000 cases in 75 different countries, something never seen before for this disease, which used to cause a few thousand cases only in some African territories, where the virus is endemic.
Now, this outbreak brings together the three points that are considered necessary to declare this global emergency: first, that the event be “serious, sudden, unusual and unexpected”; that has “implications for global health beyond a national border” and that “requires immediate international action”.
The current dynamics of monkeypox are certainly unusual, although we don’t yet know how serious they will be and they definitely spread beyond one country.
The key to last Saturday’s decision thus falls on “immediate international action” and whether it was time to ask governments around the world for it: for some members of the WHO advisory committee it was still too early to pull this lever, while for others it was too late.
The infectologist doctor Carlos Pérez, scientific adviser to France 24, positions himself on the side of those who believe that the WHO’s decision is “a little late” and “reactive”: “We always hope that there are several cases to act,” he notes, remembering especially the beginning of the Covid-19 pandemic.
What to do against the outbreak of monkeypox?
Other outbreaks deserved this level of emergency before, for example the crisis of the Zika virus, Ebola, MERS or avian flu. On all these occasions, beyond counting the number of cases and deaths to reach a certain threshold of “emergency”, what matters is “alert all countries to be synchronous” in the response to the disease and “globally face a problem”, according to Carlos Pérez.
The expert recalls that the most urgent thing now is to be able to contain this outbreak, for example with the available smallpox vaccines that are believed to protect against monkeypox, and to reinforce “global surveillance and coordination.”
“In the worst case, we will see a large increase in infections but not a large increase in mortality”, considers the infectologist, since the disease is not very lethal (only five deaths have been registered this year to date).
Other scientists fear that the virus will become endemic in countries where it has not been present to date.
Was the monkeypox outbreak preventable?
An editorial published in the magazine ‘Nature‘ harshly sentenced the lack of research and attention to zoonotic diseases, those that originate in animals: “Every zoonotic infection should be a cause for concern, but research funding seems to come only when they really affect countries high income”.
In fact, African epidemiology had been warning for years that monkeypox outbreaks in endemic countries were increasing and that the virus had the potential to jump to other regions. For the magazine ‘Nature’, funding for monkeypox and its Orthopoxvirus family should have been reactivated in 2017, when an outbreak caused thousands of infections in Nigeria.
Now, despite the fact that we have tools to contain the disease, we face this outbreak with many questions and few answers: the smallpox vaccine is believed to be effective against monkeypox, but to what extent? Do the existing treatments against smallpox really work on this occasion? What explains the mutations of this virus and how do they influence the current outbreak?
Some questions that could have been resolved when the first alarms sounded, but that only now seem important, when 80% of infections occur on the European continent.
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