- Monkeypox does not spread nearly as easily as Covid-19.
- It is also a self-limiting disease, which means hospitalisation or medical treatment is rarely required
- Experts say it is unlikely to result in a global health emergency.
Health officials and researchers are still learning about the ongoing monkeypox outbreak, which has already spread to 19 countries where the disease does not typically occur. As of 25 May, more than 200 cases had been reported.
Experts at the World Health Organization (WHO) warned that more cases are expected in the coming days, Health24 reported.
The disease is endemic in central and western Africa. There are two lineages: the West African clade and the Congo Basin clade. All cases so far that have been sampled via PCR (polymerase chain reaction) have been identified as West African clade infections.
While most parts of the world are still in the process of transitioning to normalcy two years after the Covid-19 virus swept over the globe, the news of the monkeypox outbreak has raised the alarm among the public.
But monkeypox is not like Covid-19, experts have stressed. We took a look at how the viruses differ in terms of contagiousness, severity, and how fast they evolve.
Transmission: monkeypox
The monkeypox virus, a relative of smallpox and chickenpox, was first discovered in 1958, and the first human case was in 1970, which means scientists have had plenty of time to research the virus, unlike Covid-19.
The virus typically requires very close personal contact to spread, including skin-to-skin contact, kissing, and sexual contact. Prolonged contact with clothing or bedding used by an infected person can also cause transmission.
Monkeypox enters the body through broken skin, the respiratory tract or mucous membranes (eyes, mouth or nose), Professor Dominique Goedhals, clinical virologist at Pathcare Laboratories and the Division of Virology at the University of the Free State (UFS), told Health24.
Transmission: Covid-19
Covid-19, on the other hand, spreads much faster and easily in small liquid particles when an infected person coughs, sneezes, talks, or sings. These infected droplets or tiny particles, called aerosols, reach a person’s nose or mouth.
Said Goedhals: “While monkeypox virus can be spread via the respiratory route, this occurs in the form of large droplets, rather than aerosol transmission, which is seen with SARS-CoV-2.
“Aerosols are smaller particles which can remain suspended in the air for prolonged periods which facilitates transmission of SARS-CoV-2.”
Monkeypox is therefore less contagious than Covid, since close contact is required for longer periods, she added.
Fatality rate
Monkeypox is not a deadly virus and is less likely than Covid to cause severe illness, Professor Adrian Puren, executive director of the National Institute Communicable Diseases (NICD) said this week. As a result, it is unlikely to result in a global public health emergency, even if cases rise and spread to more non-endemic countries.
The WHO notes that human infections with the West African clade have a case fatality rate (CFR) of 3.6% compared to 10.6% for the Congo Basin clade. The CFR refers to the number of confirmed deaths divided by the number of confirmed cases.
While the CFR of Covid is not constant and differs by location, data show that during the earliest stages of the outbreak, it was just over 17% across China and greater than 20% in Wuhan, the centre of the outbreak, according to Our World in Data.
How fast the viruses evolve
The monkeypox virus is a DNA virus, while SARS-CoV-2 is an RNA virus.
Speaking about monkeypox on Wednesday, Dr Jacqueline Weyer, from the NICD’s Centre for Emerging Zoonotic and Parasitic Diseases, said: “Here we are dealing with a DNA virus, and our experience with DNA viruses is that they actually don’t mutate very quickly. They’re very stable over time. And you can even find that these viruses have no changes over decades.”
Eleven of the current cases of monkeypox have gone through genome sequencing and have shown that there has virtually been no change to the virus over time.
Weyer added: “There are no changes from the [monkeypox] virus that have been recognised in recent years from Nigeria. So nothing has changed – it’s nothing we haven’t seen before, except that it’s happening in a different place.”
The fast-spreading coronavirus has mutated many times over the course of the pandemic, giving rise to new variants that caused greater disease severity and death, such as the Beta and Delta variants that drove South Africa’s second and third waves, respectively, and that were able to avoid some of the protection provided by the vaccines.
Symptoms resolve quickly
Monkeypox begins with non-specific symptoms such as fever, headache, muscle pains and swollen lymph nodes, followed by the typical skin rash. However, most cases are mild, said Goedhals.
Weyer added: “This is a self-limiting disease, so most cases don’t need any specific treatment and the infection resolves on its own. If there’s any medical intervention required, it’s usually just to help the patient deal with the symptoms they are experiencing, such as headache, body ache, itchiness of the rash, etc.”
Usually, the disease clears up within two to four weeks, depending on the severity of the rash, so all the scabs or lesions will have fallen off by then, she added. Once all the scabs have disappeared, a person is no longer considered contagious.
There are also typically no long-term side effects of the disease, as has been seen with Covid-19, where some people go on to experience symptoms months after their infection has passed (known as long Covid-19).
A note about the current cases
The people most likely to be at risk of monkeypox infection are close personal contacts of an infected person. In the current outbreak, a large proportion of cases have been in young men, many of whom self-identified as men who have sex with men.
However, this doesn’t necessarily suggest that transmission may occur through semen or other bodily fluids exchanged during sex. Instead, health officials stress that contact with infected lesions during sex may be a more likely cause.
“It is important to note that the risk of monkeypox is not limited to men who have sex with men. Anyone who has close contact with someone who is infectious is at risk,” notes the WHO.
SA is prepared
Goedhals said that since monkeypox is not highly transmissible, and “not like Covid-19 at all”, countries like South Africa can get ahead of the outbreak by doing contact tracing, monitoring, and isolating any confirmed cases.
Surveillance in several countries have been ramped up, and SA is also prepared should cases be detected here, the NICD said.
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Published on The Perfect Enemy at https://bit.ly/3LSW0MI.
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