Monkeypox: A warning that’s been ignored for years

While the Western world was astonished by the “sudden” emergence of monkeypox outbreaks, African epidemiologists were grappling with the terrible déjà vu. This viral diseasemonkeypox, in English) has been present in Central and West Africa for decades, and local scientists have for some time pointed out the possibility of the virus spreading, whose behavior has changed from the start. But if the response to infections recently recorded in Spain, Canada, the USA and the UK is timely, the same cannot be said for the resources circulating in Africa, where a more deadly strain of the virus is spreading.

Two weights, two scales. Monkeypox was ignored by Western countries until they came into close contact with them. Now that we are all in the same boat, the treatment given to patients and close contacts in different countries is by no means fair. Prior to this year, the spread of monkeypox outside Africa was barely noticeable: the most significant outbreak of the disease occurred in the United States in 2003, but only about seventy were infected.

Cases outside Africa have mostly involved people returning from the continent or had contact with imported animals: although it is not clear which species are the nature reserves of the virus – the pathogen is so named because it was first observed in some laboratory primates in 1958 – However, it is known to circulate in rodents, which can transmit it to humans.

More dangerous. As shown in temper nature, some African countries have had monkeypox since 1970, when the first human case of infection was identified in the Congo. A major outbreak erupted in Nigeria in 2017, with more than 200 confirmed cases and 500 suspected. In the past 10 years, thousands of possible cases and hundreds of suspected deaths attributable to the virus have occurred in the Democratic Republic of the Congo: moreover, the monkeypox strain circulating in Central Africa is much more virulent and more deadly, with a mortality of 10%.

A strange development. Scientists in Africa who studied these recent outbreaks noticed something strange. Before 2017, monkeypox was mainly spread in the countryside, among hunters who came into contact with infected animals. It is usually accompanied by a fever and fluid-filled blisters on the hands, feet, and face.

But after that year, it began to appear in cities, and lesions also appeared in the genital areas, indicating the presence of sexual infection or through intimate contact between humans. The same pretext that the virus now has in the West: if the alarm sounded five years ago in Africa was listened to, we would not be surprised today.

More likely. Another long-overlooked observation regarding reduced immunity to the virus due to a breakthrough in modern medicine is the eradication of smallpox (a virus related to monkeypox, but far more deadly) in 1980 and the consequent discontinuation of vaccinations against it. Therefore, the new generations are more at risk of infection monkeypox Cases in sub-Saharan Africa have been increasing for decades.

We did not learn anything. At the same time, countries where the threat was much less realistic than in Africa have amassed stockpiles of smallpox vaccines in case the virus escapes from laboratories or is used as biological weapons. These stocks are now used in France, the United Kingdom, Canada and the United States for the ring vaccination strategy, which consists of administering the vaccine to all close contacts of infected individuals.

An approach that Africa would also have adopted, if only enough vaccines were available. But Western countries have not donated their supplies to those in need in Africa, not even to protect frontline health workers. If it reminds you of something, it’s because history is repeating itself: the same thing happened with CoViD-19.

Not just vaccines. The World Health Organization has 31 million doses of smallpox vaccine donated by member states, but these are first generation vaccines, with many side effects and are not recommended against monkeypox, which is much less deadly. Even if supplies were made available to everyone, vaccines alone would not win the challenge.

In order not to consume it empty, it is first necessary to improve monitoring and diagnosis against the disease. Circular vaccination is only effective if you understand how the pathogen is spread locally. It is also necessary to understand the animals from which the virus originates and to intervene in the sourceie on the close contact between humans and wildlife.

Above all, it is necessary to act uniformly. Isolated solutions, which only solve the problem in industrialized countries, will soon foot the bill elsewhere, and then again here, in the cycles and recycling we now know.

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