There was one undiscovered Outbreak of monkeypox already underway in the US before Health authorities in Europe and the USA sounded the alarm about the dangerous viral disease in May. That’s a problem. With every day that a virus spreads unchecked and unchecked, the risk that it will find a permanent home in a country it has only visited increases. In the case of smallpox – in our pets.
Earlier this month, the US Centers for Disease Control and Prevention announced that two strains of the virus have been circulating in the country, suggesting it’s likely been here much longer than initially thought. It’s not clear when this other outbreak started, but it could possibly have been months.
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Monkeypox, which causes a rash and fever and is fatal in a very small percentage of cases, is not nearly as transmissible as Covid-19. But unlike the novel coronavirus, it spreads easily to and from certain animal populations — particularly rodents.
If the smallpox currently circulating in the US spreads to rats, hamsters, or gerbils and becomes endemic in those species, there may not be an easy way to contain it. “I share other scientists’ concerns about the containment and spread of the virus in our rodent population in the United States,” said sys Stephanie James, director of a virus testing laboratory at Regis University in Colorado.
There is good news. For starters, no one has died as a result of either of the two recent smallpox outbreaks. And authorities are better equipped than ever to contain outbreaks, thanks to large stockpiles of smallpox vaccine (which also works against monkeypox) and their years of experience in contact tracing thanks to Covid-19.
More good news: despite some mixed messages by some health experts are smallpox Not in the air in its current form. The CDC did not respond to a request for comment, but the European Center for Disease Prevention and Control — the European version of the CDC — stressed “There is no evidence of long-distance airborne transmission.”
The confusion stems from the scientific definition of “airborne”. Covid meets the definition. Monkeypox not. Smallpox can travel a very short distance with spit, but it doesn’t hover and linger in fine “aerosol” mists as it breathes and talks like Covid does in the air.
The novel coronavirus can travel through a room on aerosols or even hover in the air for hours. The monkeypox in our spit, on the other hand, quickly falls to the ground just a few meters from our mouth. “Respiratory droplets can potentially spread the virus, but it’s not what promotes transmission,” said Amesh Adalja, public health expert at the Johns Hopkins Center for Health Security. Instead, smallpox spreads through very close contact.
The bad news is we’re catching up. And as this initially undetected earlier outbreak shows, we’re not even sure how far behind we are. It is not enough to contain and treat smallpox in humans. We must also prevent it from spreading to rats and hamsters and other animals.
Monkeypox, which first spread from monkeys or rodents to humans in the Democratic Republic of Congo in 1970, regularly breaks out in Africa. But it rarely infects more than a few thousand people a year – and killed just 33 people during its longest eruption in the Democratic Republic of the Congo between 1981 and 1986.
When monkeypox spreads to places not yet endemic outside of Africa, health officials perk up. In 2003, 47 people in the US contracted smallpox after being exposed to a shipment of rodents from Ghana to Texas. A quick response from state and federal health officials — and a few doses of smallpox vaccine — prevented anyone from dying and temporarily eliminated the virus in the US
The bigger the currently The outbreaks began in early May, apparently triggered by a British traveler’s contact with an infected person or animal in Nigeria. Hitchhiking to Europe, the virus spread quickly through close physical contact. David Heymann, who used to head the World Health Organization’s emergency department, said men who attended raves in Spain and Belgium “amplified” the outbreak – apparently by kissing and rubbing the skin.
After that, the virus accompanied travelers on planes to distant and distant countries. The WHO has until June 2nd had counted 780 smallpox cases in 27 countries. Since then, the number of cases has risen to around 1,400. Health officials diagnosed the first US case on May 27.
From Friday, 49 Americans in 16 states plus Washington, DC had smallpox. The CDC suspects that some of these cases are the result of an earlier outbreak that officials didn’t even realize until the later outbreak caused them to go back and take a closer look at some patients’ symptoms.
Smallpox rashes look very similar to the symptoms of other diseases, including sexually transmitted infections, or STIs. This earlier smallpox outbreak apparently slipped past medical professionals because they didn’t necessarily know what they were looking at. “These monkeypox cases outside of the endemic area have probably been simmering for some time and have been misdiagnosed as traditional STIs,” says Adalja, the public health expert.
This delay in confirming smallpox cases worries experts. Each day that passes in the current outbreaks increases the likelihood of transmission to pets and pests. If smallpox becomes endemic in animal populations, we may never get rid of it. And countries like the US, which once experienced few smallpox outbreaks every 20 years, may experience larger and more frequent outbreaks, just as countries in Africa already do.
That is the worst case scenariobut authorities can’t contain an outbreak they don’t even know is happening. It’s a worrying sign that in the third year of a devastating pandemic, doctors, health officials and epidemiologists have overlooked this earlier smallpox outbreak, giving the virus a head start in the race for animal-endemicity. “I think we’re dramatically undertesting, underdetecting cases and underestimating the risk,” he says James Lawler, an infectious disease expert at the University of Nebraska Medical Center. “We don’t seem to have learned much from Covid.”
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