Monkeypox Concerns: ‘We Must Be Prepared’

The World Health Organization (WHO) is once again concerned about the mpox problem. Two years after an outbreak of the disease (also known as earthquake pox or, more popularly, monkeypox) spread across the world, A new strain has just been discovered in Africa. Because African countries lack the means to properly monitor the epidemic, it is impossible to know its true scale. But many are already wary because they see problems ahead.

“There are two strains of mpox. Clade I is much more aggressive, it is present mainly in the Democratic Republic of Congo and in Africa it has a mortality rate of 10%. It is more virulent and causes larger outbreaks because it is more easily transmitted between people. That’s why it’s so worrying. In Congo, there have been many more cases registered in the first six months of 2024 than in the same period last year. And 50% of those infected are under 15 years old,” says Antonio Alcami, a virologist and researcher at the CSIC’s Severo Ochoa Center for Molecular Biology.

Clade II, the expert explains, is more concentrated in Nigeria and the western part. It is the one that caused the international outbreak that spread to more than 100 countries in 2022, but its mortality rate is much lower, around 1%. The problem is that the new strain that was just discovered belongs to clade I, the most dangerous one. “We could say that it is a subtype or a variant, because it starts to have a somewhat unique sequence. That’s why they called it clade 1-B. This new lineage of transmission “It’s more aggressive than the one that caused problems in 2022, it has a higher mortality rate and it can jump to other countries.”– Alkami sums up.

We remind you that MPOX can be transmitted to humans through physical contact with an infected person, contaminated materials or infected animals, as well as through airborne droplets or short-range aerosols. According to WHO, The most common symptoms are skin rashes or mucous membrane lesions that can last from 2 to 4 weeks. accompanied by fever, headache, muscle pain, back pain, loss of energy and swollen lymph nodes.

Comparison with smallpox

Alkami compares smallpox to another well-known disease: smallpox. But while the former continues to cause problems, the latter has proven to be the only human viral disease that we have managed to eradicate through vaccination. The question then is, why? The expert himself explains: “The fight against smallpox, which has a mortality rate of up to 30% among the most virulent strains, took a long time. The WHO coordinated a global vaccination program for many years, supplying vaccines to the entire world. In 1980, it was declared eradicated, and people stopped vaccinating. After all, if it were a disease that didn’t exist, there would be no point in vaccinating against it. The problem is that over the years, we have lost immunity to this type of virus.”

An expert illustrates this clearly. The human population became 100% immune to smallpox, but since then several generations have been born who have never encountered such a virus and therefore have no immunity: “If a cousin of smallpox, such as smallpox, comes into play, there is a good chance it will be transmitted. If we had vaccinated the entire population, we would have avoided this, because the vaccine is very effective and it is as easy to protect against smallpox as against smallpox. But…”.

But it is not happening. At the moment, Africa does not have sufficient resources to implement such an ambitious plan, so they will need help from other countries. And at the moment, it is not coming. This is what is causing growing concern, but there is something else. Alkami explains that zoonotic viruses like mpox have jumped from animals to humans.. For example, with an infected rodent living in the jungle and coming into contact with people living there. But usually viruses of this type do not live long among people, and in order for them to continue to circulate among people, another animal “jump” is needed. But mpox does not need this anymore, it is here to stay, and it is among us.

The vaccine currently used against smallpox is based on the vaccine used against classical smallpox.but some things have been changed to make it safer and have fewer side effects. Although some patients, usually those with severe symptoms, may be given antiviral drugs that help them overcome the disease in a couple of weeks.

Could this strain reach Spain?

The first thing that might come to mind when reading this is Covid. But there are differences. “Coronavirus is much more contagious, it is transmitted by airborne droplets. And the problem was, first of all, that it was asymptomatic. With mpox infection, the infection is more severe, there are obvious symptoms on the skin, so it is easier to identify patients. I don’t think mpox will cause a pandemic as quickly as Covid, but we must monitor it and be prepared, because it is unpredictable,” says Alkami.

The expert hesitates when asked directly whether this could cause problems in Spain: “Clade I is more easily transmitted and has more potential to move to other countries. It is difficult to predict what impact this will have in Spain, as a large part of the population here is not immune to these viruses. And even if there are few cases, since it leads to more mortality, the consequences will be more serious.”

Alkami argues that it would also be important to see which segment of the population it will affect the most in order to assess its danger. For example, the global smallpox outbreak in 2022 was spread mainly among men who had sex with other men, but as we have seen, clade I particularly affects young children in Africa. In any case, the expert notes that there is not much research on the subject, so he reiterates that it is “difficult to predict” what will happen. Although he insists that It is important to “be prepared” and have enough vaccines to use in an “emergency situation.”