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Monkeypox: the world braces for another pandemic

22 May 2022

Just as the world was feeling confident that the worst of the two-year COVID-19 pandemic was behind us, a new pandemic is emerging: monkeypox. The United Kingdom (UK) was the first to report a case to the World Health Organisation (WHO) after an individual developed a rash on 29 April 2022 whilst on a trip to Nigeria and returned to the UK on 4 May 2022. Despite recording over 558 cases and eight deaths in the past five years, the Nigeria Centre for Disease Control says the 15 local cases reported this year “does not constitute an outbreak”.

Since the UK case was reported, there have been over 100 cases in 15 countries including Australia, Austria, Belgium (the first to announce a 21-day quarantine), Italy, Portugal, Spain, Switzerland, and the United States (US). Spain has the largest outbreak, with several cases linked to a gay sauna in Madrid. Investigators are also trying to determine if the Gran Canaria Pride Festival held between 5-15 May in the Canary Islands and attended by 80,000 people, was the super spreader event that has led to incorrect conclusions that monkeypox, which has lesions similar to syphilis, is a sexually transmitted disease.

What is monkeypox?

Monkeypox is a viral zoonotic disease and comes from the same family as smallpoxcowpox, horsepox, and camelpox.

The monkeypox virus was first identified in the Democratic Republic of Congo back in 1970 and there have been cases in ten other African countries over the years: Benin, Cameroon, the Central African Republic, Côte d’Ivoire, Gabon, Liberia, Nigeria, the Republic of Congo, Sierra Leone, and South Sudan. Nigeria continues to struggle to contain the virus.

This is not the first time the virus has spread outside Africa. Monkeypox was reported in the United States in 2003 and 2021, Israel in 2018, Singapore in 2019 and multiple times in the United Kingdom between 2018 and 2022. However, the virus seems to be spreading more quickly and across more geographies this time around.

The World Health Organisation is trying to get the jump on monkeypox after being criticised for being too slow on COVID-19.

How is monkeypox transmitted?

The transmission of the monkeypox virus is through close contact with an infected person via body fluids, breathing in respiratory droplets (released in the air by sneezing or coughing), touching infected lesions, contact with contaminated clothing and bedding, and mother-to-child transmission at childbirth.

The incubation period ranges from five days to three weeks. The rash appears within the first few days following infection and is usually starts on the face before spreading to the rest of the body. The rash is accompanied by a fever, headache, muscle aches, back pain, fatigue and swelling of lymph nodes. The disease clears within 2-4 weeks. The fatality rate is low and ranges from 3-6%, with children the most likely to have severe cases.

Is there a vaccine for monkeypox?

There is no specific vaccine for monkeypox. The smallpox vaccine is commonly used as a substitute and found to be 85% effective in preventing illness and in the remaining 15% of cases where there is a breakthrough infection, cases tend to be mild.

Who stands to benefit the monkeypox outbreak?

Pharmaceutical companies continue their winning streak. The Danish fully integrated vaccines company, Bavarian Nordic AS, saw its share price increase by nearly 30% last week after it won a $119m contract to supply the smallpox vaccine to the US government and another order from an undisclosed European country. It is considered the world leader in smallpox vaccines and its US brand, JYNNEOS®, has now been approved by the US FDA to also cover monkeypox.

What are the conspiracy theories about monkeypox?

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Bill Gates has established himself as the Oracle of International Public Health though some skeptics call him the "creator and spreader of viruses"

The latest monkeypox outbreak comes six months after US business magnate and philanthropist, Bill Gates, called for the establishment of a WHO-run, Global Epidemic Response and Mobilisation (GERM) institution, to help the world cope with the next pandemic. GERM would be staffed by 3,000 leading scientists and researchers, funded by an annual budget of $1b, mainly from the world’s wealthiest countries. It is likely that some countries will not be keen to lose control of managing their own public heath crises.

Gates, who has established himself as the Oracle of International Public Health, is currently promoting his book, How to Prevent the Next Pandemic: Bill Gates, which was published on 2 May 2022. News of monkeypox was met with some scepticism from anti-vaxxers and conspiracy theorists who recall that Gates predicted this very outbreak last year (polio could be next). Gates, who is not medically trained but appears to exert strong influence over WHO, is viewed by some critics as the “creator and spreader of viruses”.

What do you think about the latest outbreak? Please leave a comment below.