Newly-surfaced disease monkeypox has steadily become a national talking point for health media in recent weeks as infection numbers continue to mount, mainly in LGBT communities.
But if COVID-19 taught independent health-thinkers like us anything, it’s that it never hurts to better understand the world of infectious diseases, even if the likelihood of personal injury is low. Ignorance only creates a breeding ground for mismanagement and absurdity; so let’s take a moment to really dive into monkeypox, lest we find ourselves at the mercy of another government-mandated health crisis.
Firstly, monkeypox has very little to do with monkeys. Top researchers actually believe it has origins in rodents, but that monkeys contracted it at some point.
“It was first discovered in monkeys in a laboratory setting in Denmark. It does infect monkeys, and has been isolated from monkeys, but they’re not the primary reservoir for the disease,” says Sagan Friant, an anthropologist at Pennsylvania State University in the United States. “We think of a reservoir as an animal that can transmit the disease but does not suffer or die from it.”
Monkeypox causes lesions that are similar to those seen in other pox infections such as smallpox. The first outbreak in the U.S. (and outside of Africa for that matter) actually occurred about 20 years ago in 2003 when 70 cases were linked to infected prairie dogs. Some other more developed nations like the UK and Canada have also seen cases over the years, but nothing on the scale of African countries like Ghana, where monkeypox is endemic.
Scientists still know little about the disease as compared to other poxes, but they believe this current iteration gained much of its human-to-human contagion function around 2017.
How is it spread, and what are the side effects?
Monkeypox is easily spread from humans to other humans by way of (often prolonged) physical touch. It has earned the reputation as a sexually transmitted disease — mostly in gay male communities — but scientists aren’t ready to explicitly link the disease to bodily fluids like semen.
“It could be contact with someone who has an infectious rash, such as lesions, scabs and bodily fluids,” says Madeline Barron, from the American Society for Microbiology (ASM). “You can also get it by touching items that someone who’s infected may have touched.”
“We don’t know if the virus can spread specifically through sexual transmission routes, such as through vaginal secretions or semen, but it seems to be that intimate contact is promoting the spread,” she added.
As for personal danger, just about one percent of affected patients suffer life-threatening illness (which is actually higher than COVID-19 in many age groups and health ranges), though the infection rates are minute in comparison. Three deaths outside of Africa and five deaths inside of Africa have been reported this year.
However, patients dealing with monkeypox report unbearably painful side effects after infection.
“It’s long, it’s nasty and you don’t want to get it,” says Barron. “People may feel flu-like symptoms in the beginning, with fever, headache, stuff like that, but as the disease progresses you get a multi-stage rash, lesions can develop in your mouth, your feet and genital region and these develop into pus-filled blisters.”
The blisters and lesions typically begin within one to two weeks of infection, and typically proceed a fever and body aches. The blisters eventually dry and fall off on their own a few weeks later, but unfortunately, very few treatment options exist. It’s just a painful waiting game that can take up to two months in its entirety.
Monkeypox consists of a different genetic structure than COVID-19, which makes it more stable
One significant technical difference between monkeypox and COVID-19 is the genetic structure. Monkeypox is a DNA virus, which means it is stable and less likely to mutate than, say, a single-stranded RNA virus like Sars-CoV-2.
“RNA viruses mutate very effectively – they’re diabolical, in my opinion, they’re just really nasty viruses,” says Rodney Rohde, a professor at Texas State University with a background in public health and virology. “DNA viruses typically don’t mutate that quickly, even with the 50 mutations we’ve seen (in monkeypox), so we don’t see mutations having an impact on the severity of the disease.”
Strangely enough, the “stable” virus has seen a handful of mutations in recent years, which may explain its sudden prevalence in modern society.
Another aspect of this new outbreak that interests (and maybe worries) researchers is the disease’s close relation to smallpox. Smallpox was declared “totally eradicated” from the entire globe back in 1980 thanks to worldwide vaccine efforts. Pox viruses just don’t really pack the same punch as they once did thanks to modern medicine, which is both good and bad — bad because human beings carry very little natural immunity to them anymore.
“We probably had a pretty strong herd immunity across the globe when we eradicated smallpox,” says Rohde. “There’s some research that shows that if you go back and look at the population in Nigeria, for example, they probably would have spread monkeypox more efficiently had they not been vaccinated against smallpox.
“Once we stopped smallpox vaccinations, we had waning antibodies – my parents, for example, may have some immunity, but it’s probably really poor.”
Why are the US and other developed nations unready for the disease?
Therefore, monkeypox-adjacent immunity may not really exist in human beings anymore. And since the disease existed almost exclusively in Africa for 50 years, modernized nations are not well-prepared in terms of infrastructure.
“Many of us have been screaming about these types of issues for decades,” says Rohde. “In my opinion we don’t always think about these things when they’re not on our shores.”
Anthropologist Sagan Friant agrees.
“We need more investment in understanding the diseases and preventing that initial spill-over event from animals to humans from happening,” she says. “We also need collaboration and capacity building in countries so that they’re equipped to respond to these events – it definitely shouldn’t just be about protecting the Western world.”