Lauren Dempsey, MS in Biomedicine and Law, RN, FISM News
Earlier this month cases of monkeypox were reported across the globe, seemingly all unrelated. Now, with about 140 total reported cases, researchers are scrambling to determine how this outbreak occurred in dozens of countries across Europe, Israel, Australia, and the United States. Reportedly, none of the infected individuals had traveled to areas where monkeypox is endemic such as Nigeria, Cameroon, or the Democratic Republic of the Congo, but experts believe that the spread may be the result of sexual activity at two recent raves in Europe.
Scientists have made one casual connection that suggests a new way the virus is spread. All but one of the individuals who contracted the virus were men and some experts caution that the LBGTQ+ community may face a higher risk. Dr. Susan Hopkins Chief Medical Adviser at the U.K. Health Security Agency said in a statement “The evidence suggests that there may be transmission of the monkeypox virus in the community, spread by close contact,” adding “We are particularly urging men who are gay and bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay.”
According to AP, the former head of WHO’s emergencies department and a professor of infectious diseases at the London School of Hygiene and Tropical Medicine, Dr. David Heymann, has stated that the leading theory to explain the outbreak is sexual transmission among men at raves held in Spain and Belgium. “We know monkeypox can spread when there is close contact with the lesions of someone who is infected, and it looks like sexual contact has now amplified that transmission,” said Heymann.
“It’s very possible there was somebody who got infected, developed lesions on the genitals, hands or somewhere else, and then spread it to others when there was sexual or close, physical contact,” Heymann commented. “And then there were these international events that seeded the outbreak around the world, into the U.S. and other European countries.”
Monkeypox is spread through close contact with an infected person or animal and symptoms include fever, headache, sore muscles, swollen lymph nodes, exhaustion, and lesions. Direct contact with respiratory droplets, body fluids, or lesions can lead to transmission. The virus generally resolves on its own and does not require hospitalization. However, 6-10% of cases lead to death and there is no current treatment for the virus.
The first case in the U.S. was identified as an adult male from Massachusetts with recent travel to Canada. While concerning, this is not the first outbreak to occur in the U.S. According to the CDC, there were two cases in 2021 in people who had traveled to Nigeria, and in 2003, there were 47 cases across six states that were linked to animals imported from Ghana.
Vaccines against smallpox appear to be effective in preventing monkeypox and some antiviral drugs are in the process of being developed for treatment. The U.S. government placed a $119 million order from Bavarian Nordic, a biotech company that makes the smallpox vaccine, and has the option to buy $180 million more. This would provide about 13 million doses of the smallpox vaccine available for administration in the United States. President and CEO of Bavarian Nordic, Paul Chaplin said in a statement: “We are pleased to announce the exercise of the first options under our contract with the U.S. government to deliver a freeze-dried version of the smallpox vaccine with an improved shelf-life.” He added that this “marks a significant milestone in our long-standing partnership with the U.S. government to ensure availability of life-saving vaccines for the entire population.”
Last week President Biden indicated he does not expect the U.S. to issue any quarantine requirements saying “I just don’t think it rises to the level of the kind of concern that existed with COVID-19, and the smallpox vaccine works for it. But, I think people should be careful.”
Interestingly, the Nuclear Threat Initiative and the Munich Security Conference hosted a tabletop exercise in 2021 to simulate a global response to a monkeypox pandemic and made recommendations on “gaps in national and international biosecurity and pandemic preparedness.” The CDC is not currently concerned that this will lead to an outbreak; however, the agency said that “in the event of another outbreak of monkeypox in the U.S., CDC will establish guidelines explaining who should be vaccinated.” The agency is continuing to monitor the situation.