There are no clear answers about how humans are infected, as the host animal has not been identified
There are no clear answers about how humans are infected, as the host animal has not been identified
Monkeypox was first reported in 1958 in laboratory monkeys, and the first human case was reported in 1970 in a nine-month-old baby in the Democratic Republic of the Congo. Nigeria reported its first case of monkeypox in humans in 1970, when a case was discovered; there were two cases of monkeypox in humans in Nigeria in 1978. And after almost four decades without reporting, the monkeypox (West African firewood) reappeared in Nigeria in September 2017. From September 2017 to April 30, 2022 ., Nigeria has reported 558 cases, of which 231 have been laboratory confirmed. There are dozens of confirmed cases in Nigeria every year since 2017 – 88 in 2017, 49 in 2018, 47 in 2019, eight in 2020 and 34 in 2021. There were 15 confirmed cases between 1 January and April 30, 2020
Based on the epidemiological and clinical characteristics of 122 confirmed or probable cases of human monkeypox in Nigeria between September 22, 2017 and September 16, 2018, the researchers found both primary zoonotic transmission and human-to-human transmission. Two cases of healthcare associated infection have been reported. Based on genome sequencing, the researchers found multiple introductions of the virus and a single introduction along with human-to-human transmission in a prison facility. The results were published in the journal Lancet infectious diseases.
Since the outbreak began in Nigeria in 2017 and before the last outbreak in Europe and North America, there have been at least eight cases of smallpox being exported to countries outside Africa – the United Kingdom, the United States, Israel and Singapore. Like all diseases that are endemic to Africa alone, history repeats itself. Although efforts have been made to prevent an outbreak in non-endemic countries outside Africa, no serious international attempts have been made to stem the outbreak in Nigeria or to study the characteristics of the virus.
According to Stat news, Dr. Chikwe Ihekweazou, former director general of the Nigerian Center for Disease Control, has sought help to try to decipher what is happening to monkeypox, but without success. While in 2003 the United States reported the first case of human monkeypox, the virus crossed the species barrier from rodents imported from Ghana to just one person. Human-to-human transmission outside Africa was first reported in September 2018, when the monkeypox virus spread from a patient to a healthcare professional in the UK
Current explosion
The current outbreak in Europe and North America is the first time a large-scale human-to-human transmission has been reported outside of Africa. The index case is a UK resident who travels to Nigeria on April 20 and returns on May 3; he was diagnosed with monkeypox on May 6, 2022. Since then, it has spread to 219 people as of May 25 in 20 countries.
Wealthy nations are now waking up to the reality of monkeypox, which crosses international borders and causes outbreaks in countries where it is not endemic.
“Attention is only paid when certain diseases affect high-income countries, which is an example of our collective failure to properly deal with ‘epidemic preparedness’ and ‘global health’. It also illustrates the double standard applied to how people’s health is assessed between rich countries and the rest of the world, ”said Dr. Emanuel Nakoune of the Pasteur Bangui Institute, Central African Republic, and Dr. Piero Oliaro of the Pandemic Institute, Oxford University. write in BMJ.
There are no clear answers as to how humans are infected, as the host animal, which behaves as a reservoir for the virus, has not been identified in the wild. And how the virus spreads from animals to humans is unknown.
It is also not clear to how many people an average infected person will spread the virus.
“So far, there has been little interest in supporting this work – unfortunately,” said Dr Ihekweazou. Stat news. “He never really got the interest he needed to answer some of those questions.”
It seems that the current epidemic has spread mainly among men who have sex with men. The virus is not transmitted through semen or vaginal fluids, but skin-to-skin contact during sex can spread the virus.
Project genomic sequences, published first by researchers in Portugal and then in Belgium, show that the virus, which is circulating in Europe and North America, belongs to the West African firewood, which causes a mild infection.
Low degree of mutation
To date, more than 15 genomes of monkeypox have been sequenced. But the monkeypox virus has a lower mutation rate (about two mutations per year) than nearly 25 mutations in one year in the case of the SARS-CoV-2 virus.
This is because monkeypox is a DNA virus, unlike SARS-CoV-2, which is an RNA virus.
The low degree of mutation in DNA viruses is largely due to differences in the mechanisms that create the mutation, as well as the correction reading mechanisms used by viruses.
“The rate at which monkeypox mutations are not well known, but in general other measles viruses have a much lower mutation rate. But almost all outbreaks are due to the spread of animals, while long-term human-to-human transmission and sequences of such events are not widely available to accurately estimate the frequency, “said Dr. Vinod Scaria, a senior scientist at the Institute of Genomics. integrative biology (CSIR-IGIB).
Genomic sequencing
Despite the low mutation rate, sequencing more genomes may be reasonable, especially in terms of genetic epidemiology.
According to Dr. Scaria, in addition to providing insights into the phenomenon, genetic epidemiology helps to understand evolution through observation and contact networks with fine traces.
“The first is still applicable, while even with the loss of resolution, the second is still useful,” he said.
Although an additional mutation has been found in sequenced genomes, more genomic sequences and epidemiological insights are needed to definitively determine what this mutation actually means. The mutation is unlikely to have made the virus more transmissible, although a large number of cases have been reported.
This is because two rave parties in Spain and Belgium turned out to be super-common events, leading to reported cases from many countries. It is not yet clear whether the virus has acquired the ability to be transmitted for a long time in humans.
“Many of the new cases seem to have come from people who have no travel history or some contact with a person who has traveled. It is too early to say [due to] prolonged human-to-human transmission, ”says Dr. Scaria.
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