As the number of registered cases of monkeypox grows people are becoming more worried about the disease. Since May 2022, the global tally of monkeypox cases has passed 800 in under one month and continues to increase across more than two dozen countries where the virus is not typically found, according to the latest report from the World Health Organization. Should we be worried about a monkeypox pandemic? Let’s see how global health experts respond to that question.
Key Takeaways:
- Monkeypox is a zoonotic disease and is currently the most prevalent orthopoxviral infection in humans after the eradication of smallpox and the cessation of the universal smallpox vaccination.
- Since 13 May 2022, and as of 15 June 2022, over 2,000 laboratory-confirmed cases of monkeypox have been reported to or identified by WHO from 42 Member States across four WHO regions that are not endemic for the monkeypox virus.
- Among the triggers that spark viral outbreaks from animals to humans are consumerism and the strive for economic growth at all costs which have a huge negative impact on the local population, environment, and soil with diminishing living habitat for animals and plants
- According to the majority of global health experts, it is unlikely that monkeypox will cause a dangerous spread similar to that experienced during COVID-19.
What do you think has sparked the recent viral outbreaks from animals to humans?
“Looking back in history how civilizations have evolved suggests that disregarding earth as our base of living, taking resources and diversity for granted, extensive exploitation due to constant consumerism, the strive for economic growth at all costs have all had a huge negative impact on the local population, environment, and soil with diminishing living habitats for animals and plants. The more natural habitat of animals is taken, the more likely they are to search for alternatives. Likewise, the poorer the population, the more likely people are to hunt and consume animals like bats, monkeys, etc. Also, certain beliefs may spark the consumption of particular body parts of specific animals (i.e., monkey brain, etc.). There is a great disregard on how earth resources are being utilized and an even bigger out-of-balance synergy of the beings living on this planet.”
Monkeypox is a zoonotic infection which means it began in animals and was transmitted to humans. It is endemic to Africa and transmitted when someone has close contact with another monkeypox patient or from rodents carrying the disease. The current outbreak illustrates how easy human-to-human transmissibility is through direct contact with lesions that contain the virus. The outbreak may have been recently triggered by the war in Ukraine after Russian’s invasion. Millions have been displaced and are migrating. The period between leaving Ukraine and reaching a destination as a refugee carries a risk of getting a zoonotic infection. Owing to the pressure to take in more refugees due to the escalation of the war, the protocols for screening for zoonotic infection have been suboptimal, and, coupled with increasing migration, the infection has continued to spread subclinically between countries.
“Zoonotic infections are not new. They are caused by all types of pathogenic agents, including bacteria, parasites, fungi, viruses, and prions. They have always featured among the wide range of human diseases and most, e.g., anthrax, tuberculosis, plague, yellow fever, and influenza, have come from domestic animals, poultry, and livestock. However, with changes in the environment, human behavior, and habitat, increasingly these infections are emerging. It has been noted by the WHO that approximately 75% of new emerging human infectious diseases are defined as zoonotic. The new and re-emerging zoonoses have evolved in recent years partly as a consequence of the increasing interdependence of humans on animals and our close association with companion animals. As early as in 2003, of the 1,461 infectious diseases recognized to occur in humans by the National Academy of Sciences, Institute of Medicine, approximately 60% were caused by multi-host pathogens, characterized by their movement across various species (animals to humans and vice versa).
“Based on various readings from “somehow authentic” sources, I would answer the question by arguing that the viral outbreaks from animals to human in recent times can be attributed to human-induced upheavals of the animal world, deforestation, mass livestock cultivation, and climate change. However, according to other sources, these diseases are manufactured in various laboratories across the world by humans who then use the animal sources as a cover-up although the initial diseases may have been animal to humans. Again, another question will be, what is the rationale behind manufacturing such hazardous diseases? Is it to purposely destroy weak and poor populations or is it human error that backfires?”
Is monkeypox the next big pandemic? Argument your position
Monkeypox is not the next big pandemic because the infection is transmitted through direct contact hence the infection rate is low. There is likely a herd immunity in endemic regions. The infection is clinically recognizable as the lesions evolve from macules, papules, vesicles, and pustules as well as ulcers, which makes it easy to identify and avoid direct contact with those infected thus reducing the risk of transmission. The disease is less lethal as the case fatality ratio is about 0% to 11% historically, but has been between 3% – 6% in recent times. Recovering from COVID-19, most countries have improved their infection prevention measures, surveillance, and hospital capacity to deal with infectious disease and there are existing protocols for infection prevention globally due to the COVID-19 pandemic. Finally, the clinical presentation of monkeypox is similar to smallpox which has been eradicated. This means that despite the eradication of smallpox, the global health sector is still very vigilant in efforts to forestall any likelihood of its re-emergence and newer vaccines are being developed, diagnostics and antiviral agents are being developed which may also prove useful for the control of monkeypox since it has similar pattern to smallpox.
According to WHO, monkeypox is usually a self-limiting disease with symptoms lasting 2-4 weeks although severe cases can occur. In recent years, the case fatality rate has been between 3% and 6%. The clinical presentation of monkeypox resembles that of smallpox, a related orthopoxviral infection which was declared to have been eradicated worldwide in 1980. It is less contagious than smallpox and causes less severe illness. Also, according to the Centre for Global Health (Usher Institute, The University of Edinburgh), the spread of monkeypox is expected to be quite different from COVID-19 and it should be more easily containable, while the stockpiled smallpox vaccines may also be deployed to assist in breaking the chains of transmission. It would therefore be unlikely that monkeypox would be the next big worldwide pandemic. But this should not alter the urgency and importance of examining the health effects of monkeypox to fully understand the public health and economic impact of this disease and to assist in the implementation of effective treatment and prevention programs.”
“According to various medics who have deliberated on monkeypox, I don’t think it’s the next big pandemic because death is not particularly associated with monkeypox as instead, it destroys human skin due to the pimples and rashes.
“The risk of monkeypox reported in non-endemic countries is troubling. Some countries are reporting community transmission including transmission among women. The world is at an early stage of understanding this virus and its outbreak and how to contain it. Given its brief history in the nineteen century and the advancement of science and technology, it might not be the next big pandemic. There are two vaccines licensed against monkeypox. However, monkeypox requires much closer contact in order to spread compared to COVID-19. Based on the current understanding it is unlikely to cause the kind of dangerous spread that the world experienced in case of COVID.”
How do you perceive the current WHO actions in this matter?
“I believe that WHO’s current actions must be undertaken within a coordinated framework with other relevant UN institutions. Indeed, it is being increasingly recognised that a One Health approach at the human–animal– ecosystem interface is needed for the effective investigation, prevention, and control of any emerging zoonotic disease. So, it is imperative that the WHO, the Food and Agriculture Organization of the United Nations, and the World Organisation for Animal Health have a joint consultation so that we can be more effective in the fight against monkeypox. This consultation is especially important because governments, health officials, and scientists at all levels and in all nations, as well as most infectious disease experts, agree that the source of the next human pandemic is likely to be zoonotic with wildlife emerging as the primary source.”
“WHO must learn from the COVID outbreak. The novel pandemic alerted the world to think about One Health – human, animal, and plant health and nutrition together. The relevance of One Health has grown due to rapid interactions between people, animals, plants, and the environment. A global watchdog created by the UN General Assembly needs to be in place. Given past experience, WHO must look forward to a leadership agenda of action with more powerful global effort, for example, the UN General Assembly taking the central role with a focus that is inclusive and accountable and offers caring health systems.”
“WHO is a global body that needs to be viewed with confidence by all member states because, despite all the odds and misgivings, WHO has done a reasonably good job in managing the world during the recent and ongoing pandemic. We can argue back and forth on the issue and methods adopted by WHO but it remains a fact that the world without such an organization would be in a bigger mess. Reasonable checks and balances help any organization to flourish and live up to the task and by the same token, we have to understand that any organization can crumble under constant intimidation, especially from fake media. With this background in mind, we should now look at WHO’s role so far to collect data, synthesize, triangulate, verify, analyze and then spread awareness about monkeypox or any other future health issue. Having seen WHO raise alarms about vaccines and slogans like health for all, the world’s corporate greed is just not ready to listen to anyone, and, by anyone, I mean even WHO. Monkeypox might spread, the scientific community might be able to enlighten us on this but what I do know as a social scientist that having worked in fragile and crumbling states across the world, data is hard to collect, verify and analyze. On top of these difficulties now comes the fear of corporate entities manipulating the data, the media, and people in such a way that WHO or any public health organization might find it difficult to predict with authenticity and confidence any public outbreak. We have to understand that it’s a matter of life and death and the survival of humanity and we should all let WHO work for the people with access to data and time to analyze. WHO for its part, besides focusing on the scientific data, should not be intimidated by any fake media or influence but should rather focus on coming up with the best possible scientific evidence and then spread this in a way that will not kick start a panic attack in the media or the world, but should focus on positive messaging that should have caution, care and hope embedded into every word that comes out from the mouth of any spokesperson of WHO.”
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