Monkey Pox

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Five Things to Know About Monkeypox

Monkeypox has now been declared a public health emergency in the US and a global emergency by the World Health Organization. What do we know about this virus and the current outbreak? During Aspen Ideas: Health 2022, Helen Branswell of STAT gave an explainer about monkeypox, highlighting five interesting things to know about the world's latest infectious disease concern.

  • August 4th 2022

The following excerpts are from Helen Branswell's explainer on monkeypox, which took place on June 24, 2022, at Aspen Ideas: Health. For the latest information on the monkeypox outbreak, please visit the CDC's website.

1) Monkeypox is part of the poxvirus family

“It's related to smallpox, cowpox, horsepox – there are a whole bunch of poxviruses. It is not related to chickenpox, which is not in the poxvirus family. Although, chickenpox lesions can often be confused for monkeypox, or monkeypox can be confused for chickenpox in parts of the world where they don't use chickenpox vaccine and chickenpox still circulates a lot. One of the ways that doctors are told to differentiate between the two is that chickenpox itch and monkeypox lesions hurt and apparently, they're very painful. The relatedness of monkeypox to smallpox means that vaccines and drugs that were developed, as a consequence of US investment for bioterror reasons, can be used against monkeypox and its thought that there would be fairly decent efficacy.”

2) Monkeypox does not come from monkeys

“It, unfortunately, gets that name because the first time it was seen was in 1958 in research monkeys. Monkeys are susceptible to it, but they are not the primary host of this virus. It's not clear at present where this virus actually lives in nature. In the countries where it's considered endemic, it's thought to live in small rodents that live in the forest, like types of squirrels, things like Gambian pouched rats have been found to be infected. But the true reservoir, the host that can carry this without being sick, hasn't been definitively established at present. And it could be more than one. The first human cases were seen in 1970. And it was rare until about 2017.”

3) Monkeypox is endemic in some countries in West and Central Africa, but the latest global outbreak is challenging what was previously known about the virus

“So, places like Nigeria, Ghana, the Democratic Republic of Congo, the Central African Republic. They're about nine countries through there where traditionally they've seen human cases, and/or just evidence of the virus in animals. In those countries, the endemic countries, often what has happened is you've had cases where a kid or a bunch of kids have been hunting in the forest for small rodents. They catch an animal, they get infected, they might infect somebody in their household, but it's been very, very limited person to person spread. It's mostly from the animal to the people, and then it dies out. That's not what we're seeing here. What we're seeing here is generations of human-to-human-to-human spread. You may know this term, but this virus is as zoonotic pathogen. It's something that jumps from animals to people. We could see reverse zoonosis with this virus, especially if it continues to spread. I don't know if you've noticed this, but some of the places that are having cases in this outbreak have urged people who are infected not to have contact with animals, pets, because there is a real concern that people could infect susceptible animals and through that, we could end up getting this virus entrenched in new parts of the world, like in Europe, in the Americas."

4) The name of the virus and its strains may change to address concerns about accuracy and stigmatization

“Nobody likes the name “monkeypox”. For one, it isn't accurate. And it conjures up a lot of images that I don't think people feel are very helpful. And another thing about it is there are strains of the virus. Within monkeypox, there are two clades, which are really just families of viruses. One of them is from West Africa and it's the milder of the two. It is the one that is responsible for this outbreak that we're seeing now. The other is from Central Africa. It's called the Congo Basin clade and it has a higher mortality rate… A couple of weeks ago, a group of scientists, led by some scientists from Africa, wrote a very sort of heated commentary, complaining about the naming, especially with the clades. What they said was this stigmatizes our countries and it runs afoul, frankly, of recommendations that the World Health Organization has established. It's long been frowned upon to name a pathogen by the place where it was discovered or by the name of the person who discovered it.”

“So, the World Health Organization has heard these complaints about the name, the names that are associated with monkeypox, and they're very receptive to changing it… The naming of viruses falls to an organization called the International Committee on Taxonomy of Viruses and they are looking at it. I think they too are receptive to making some changes. But all this to say, at some point in the not-too-distant future, we're not going to be talking about the West African clade and the Congo Basin clade.”

Read Helen’s latest reporting on the campaign to rename monkeypox.

5) The prospects of containment of this outbreak continue to evolve

“Stopping this is going to be challenging. As far as anyone knows, this is spreading mostly in men who have sex with men, but there are some women. And as time goes on, there will likely be more. This virus is spread by contact mainly, so if somebody is infected and has skin-to skin-contact with somebody else, even if they're not having sex, then you can transmit. It may be within a community, but it won't stay within that community, if it continues to spread. Most of the reported cases [for this outbreak] have been in Europe and the Americas, but some cases are starting to pop up in Asia and Australia has had some cases.”

Read Helen’s latest reporting on containment of the monkeypox virus and vaccine access.


For the latest information about the monkeypox outbreak, visit the CDC website.

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