May 30, 2022 17:00:00

Experts answer four questions about 'monkeypox' that WHO is wary of due to unusual spread of infection

Since May 2022, the number of patients with the viral infection '

monkeypox ', which is rarely confirmed outside Africa, has increased rapidly in Europe and the United States, and the World Health Organization (WHO) announced on May 29 that '23 countries in Europe and the United States'. A total of 257 monkeypox cases have been identified in Japan . ' The WHO also has the scientific journal Nature summarizing the views of various experts on the 'four important questions' about monkeypox, which calls for continued vigilance.

Monkeypox outbreaks: 4 key questions researchers have
https://doi.org/10.1038/d41586-022-01493-6

Monkeypox is caused by infection with the monkeypox virus and presents with symptoms similar tosmallpox , which once raged around the world. People infected with monkeypox virus develop influenza-like symptoms such as fever, headache, swelling of lymph nodes, myalgia, and malaise after an average latency period of 12 days, and blisters 1 to 3 days after the onset. Will appear on the face, palms, soles of the feet, etc.

What kind of disease is the infectious disease 'monkeypox' that is spreading in Europe and the Americas? --GIGAZINE

The 'four important questions about monkeypox' that Nature has taken up are as follows.

◆ 1: How did this epidemic begin?
Since the outbreak began, researchers have been analyzing the genomes of viruses collected from monkeypox patients identified in countries such as Belgium, France, Germany, Portugal, and the United States, all of which have been sequenced in West Africa. It has been found to be very similar to the monkeypox virus strains found. There are two types of monkeypox virus, West African strains and Central African strains. Central African strains have a case fatality rate of nearly 10%, while West African strains have a case fatality rate of less than 1% even in poor rural areas, which is relatively dangerous. It can be said that the stock is low in degree.

In addition, the genome sequences identified by the genome analysis so far are almost the same, and it is highly possible that the monkeypox epidemic in Europe and the United States is caused by a single case. Bernard Moss, a virologist at the National Institute of Allergy and Infectious Diseases, said, 'The'first infected person'who visited West Africa came into contact with the virus-carrying animal or human and brought it to Western countries. It is a scenario. Meanwhile, Gustavo Palacios, a virologist at Mount Sinai Medical College , said that the monkeypox virus brought to Europe and the United States during the 2018 and 2019 epidemics circulates among humans and animals, which is revealed this time. Although it is said that there is still a possibility that it has occurred, monkeypox generally has visible symptoms, so the possibility of this scenario is low.

◆ 2: Is this epidemic caused by a genetic mutation in the virus?
In the new coronavirus infection (COVID-19), which has caused great turmoil around the world, it is known that the virus repeats mutations one after another to change its infectivity. However, according to Elliot Lefkowitzs, a virologist at the

University of Alabama , it is difficult to determine whether the monkeypox virus is as infectious as the new coronavirus.

Lefkowitzs points out that the reason for this is that the monkeypox virus has a much larger genome than other viruses and is more than six times as large as the new coronavirus, making it difficult to analyze. In addition, Palacios said that little money has been invested in genome sequence analysis in Africa, where monkeypox virus has been prevalent so far, and 'the original monkey' to be compared with the newly confirmed monkeypox virus in Europe. It states that the 'genome sequence of the monkeypox virus' is small. Ifedayo Adetifa, director of the Centers for Disease Control and Prevention in Nigeria , said African virologists have been struggling to raise money for research on the monkeypox virus for many years, but public health officials around the world have seen the spread of the virus in the West. He states that he is paying attention.

To understand the evolution of monkeypox virus, Palacios said it may be useful to compare the genome sequence with monkeypox virus collected from animals such as the rodents, which are the main carriers of monkeypox virus. is. However, so far, no animal group that has been a reservoir for monkeypox virus has been found in Africa.

◆ 3: Is it possible to contain the fashion?
Since the monkeypox virus is similar to the smallpox virus, it is thought that the smallpox vaccine is also effective in controlling the infection of monkeypox, and in some countries, the smallpox vaccine is used after the outbreak of this epidemic. Is procuring. According to the Centers for Disease Control and Prevention (CDC), monkeypox virus has a long latency period, so if the smallpox vaccine can be given within 4 days of infection with monkeypox virus, the onset can be suppressed.

If smallpox vaccine can be deployed, siege vaccination (ring vaccination) is expected to be deployed to people who are close contacts of patients who have already developed monkeypox. The CDC epidemiologist Andrea McCollum says the CDC has not yet developed a siege vaccination strategy, but foreign media CNN plans to provide smallpox vaccines to healthcare professionals treating patients. It is

reported that there is .

Another concern is the scenario in which the monkeypox virus that has spread in humans infects pets and wild animals, and animals in Western countries become the source of the monkeypox virus. The European Center for Disease Control and Prevention acknowledges this possibility in a May 23 (PDF file) report , but states that it is very unlikely. Nonetheless, European health officials recommend quarantining or euthanizing rodents such as hamsters and guinea pigs owned by people infected with the monkeypox virus to prevent the spread of the infection.

◆ 4: Is this epidemic different from the previous one?
The monkeypox virus is transmitted by close contact with the body fluids of infected people and animals and the flying fly contained in the respiratory tract, but in this epidemic, there are multiple cases that 'the infection may have spread due to sex between men'. Health agency says.

The epidemic of 'monkeypox' in Europe may have spread through sex between men --GIGAZINE

However, this does not mean that 'monkeypox virus has evolved to be transmitted by sexual intercourse', but it seems that it is only a story that monkeypox virus is easily infected because they are in close contact with each other during sexual intercourse. .. In addition, since monkeypox virus survives for a relatively long time in the human body, it is possible that infection may occur through bed sheets or doorknobs. Therefore, the situation that 'the infection is spreading due to sex between men' is thought to be caused by the fact that the infected person of the virus happened to be in a small community.

McCollum said the epidemic of the monkeypox virus in Western countries has revealed that the virus may not yet be understood. 'Once everything has settled down, we will have to think hard for a long time about where our research priorities are,' he said.