As if a pandemic were not enough, a dangerous new virus is spreading around the world. From about two weeks ago, monkey pox – a pathogen that originates in West and Central Africa and causes flu-like symptoms and rashes – appeared in places where it is not normally found.
Portugal, Spain and the United Kingdom have reported a few dozen cases between them. And now the United States. Authorities in Massachusetts discovered the infection Tuesday night, and the U.S. Centers for Disease Control and Prevention confirmed it quickly.
But do not panic. The world has previously contained outbreaks of monkey pox. And we’re even better prepared for the virus now that we’ve had three years of practice the coronavirus.
“I’m not worried about anything resembling an outbreak,” Irwin Redlener, founder of Columbia University’s National Center for Disaster Preparedness, told The Daily Beast. He used the epidemiological definition of outbreak, which is a sudden spread of an unusual disease, but in a small geographical area rather than globally.
The handful of monkey cups in a handful of countries do not yet qualify as an outbreak according to the standards of many scientists. Can the virus spread to more people in more countries? Yes. But do not expect it to be anything like this the spread of COVID. “SARS-CoV is much more contagious than other infections,” Stephanie James, head of a viral testing laboratory at Regis University in Colorado, told The Daily Beast.
Slower spread means authorities have more time to confirm cases, isolate infected people and track their recent contact with others. There is no monkey cup specific vaccinebut the virus resembles smallpox, so smallpox vaccines should be reasonably effective – and a useful tool for blocking smallpox transmission once contact tracers have identified the people at risk.
That was what happened in 2003, the last time monkey cups gained a significant foothold in the United States – that time via pet rodents sent to Texas from Ghana in West Africa. Forty-seven people became ill, but a quick response from state and federal health officials – and a few doses of smallpox vaccine – prevented someone from dying and quickly, albeit temporarily, eliminated the virus in the United States.
Monkey cups, which first took the leap from monkeys or rodents to humans in the Democratic Republic of Congo in Central Africa in 1970, flare up here and there from time to time – usually in Africa. But it rarely infects more than a few thousand people a year – killing only 33 people during its most prolonged outbreak in the DRC between 1981 and 1986.
There are good reasons why monkey pox is not nearly as contagious as COVID. Where COVID is spread via very fine droplets of saliva – the kind that we all vomit in meters in all directions every time we breathe, talk, laugh or cough – monkey cups prefer larger droplets that do not travel very far. It can also be spread via direct contact between the pathogen and an open wound, but that transmission path is even less likely than the large, rapidly falling droplets.
The key to containing monkey cups is to identify it quickly so that isolation, contact detection and treatment can begin before the virus spreads too far. We were pretty good at that a generation ago. We are even better at it now, not least thanks to COVID. “Most of the world is much better prepared for monkey pox than we were two and a half years ago,” Paul Anantharajah Tambyah, president of the Asia Pacific Society of Clinical Microbiology and Infection in Singapore, told The Daily Beast.
“We need to find out what’s happening – fast.”
Testing is more sophisticated – not just for SARS-CoV-2 infections, but for a wide range of viral diseases. “I would like to think we have learned how to perform mass testing more efficiently,” James said. “PCR tests are actually easy as long as we have the right reagents. We can also test for multiple viruses at the same time.”
We are also better at tracking contact. Examining people’s movements and conditions to map out who they have come in close contact with and when, was a niche practice three years ago. Today, many tens of thousands of healthcare workers around the world have experience with contact tracing.
The general public is also paying more attention. Of course, COVID-related restrictions on schools, businesses and travel annoy many people. No one loves to wear a mask. Small but stubborn minorities in some countries even refuse to take the free, safe and effective vaccines that offer strong protection against the worst outcomes of a COVID infection.
But that stubbornness contradicts the deep consciousness most people now have when it comes to viral diseases. People are likely to notice if a friend, neighbor or family member comes down with the cup – and they are likely to take it seriously. “The Covid-19 pandemic has shed light on the critical importance of being at the forefront of threats to infectious diseases instead of constantly chasing them,” Anne Rimoin, professor of epidemiology at UCLA Fielding School of Public Health, told The Daily Beast. “The world is now familiar with the concepts of ‘case study’, ‘contact tracing’ and ‘genomic sequencing’.”
It is perhaps most reassuring that we have already received a vaccine. With COVID we had to lock down and wait a year before the first jabs were ready. But since the smallpox vaccine works on monkey pox, there is no waiting time.
If there is cause for concern in the recent wave of monkey cups, it is that we do not yet know exactly where and how it started. Of course, identifying the origin of a viral spread helps to limit it. “We need to find out what’s going on – quickly,” James Lawler, an expert in infectious diseases at the University of Nebraska Medical Center, told The Daily Beast.
“That said, we generally see monkey pox as much less lethal than smallpox, easier to control in terms of transmission and susceptible to vaccines and antiviral agents,” Lawler added.
All this is to say, do not worry. Unless a contact trail comes and knocks on (an unlikely suggestion), or you notice strange blisters on your neighbor or yourself (even more unlikely), you do not need to do anything different. “The risk to the public is very low,” Rimoin said.
Monkeypox makes one of its periodic comebacks. But this is a virus we are really good at curbing.