History is filled with instances where a minor viral infection had a significant impact. In recent weeks, a new disease affecting the world has surfaced, which might impact us gravely. It’s the monkeypox we’re talking about. While the world is still reeling from the Covid-19 pandemic, global health experts have been on high alert after reports of another possible outbreak.
It is a rare disease caused by a viral infection of the Monkeypox virus (similar to the variola virus causing smallpox or orthopoxvirus genus). This virus was first reported in 1958, but recently, its cases are coming to light. Monkeypox is similar to smallpox and measles, but it spreads gradually from person-to-person.
It is a zoonotic infection prevalent in the Congo basin and West Africa. Its resemblance to smallpox disease, increased vulnerability to infections in human groups, lack of a definite treatment, and potential use as a bioweapons instrument highlight its public health significance.
In a report by the Centers for Disease Control and Prevention (CDC), the total confirmed cases globally account for 3504 in around 44 countries. Out of these 42 countries, the United Kingdom (UK) accounts for 793 cases, leading the numbers, whereas the United States (US) accounts for 155 cases. Below is the graph depicting the countries with the highest number of cases of monkeypox throughout the globe.
It’s unclear how the victims got monkeypox. Still, preliminary statistics show that homosexual, bisexual, and other males who have been indulging in sexual activities with men account for a sizable proportion of cases. On the other hand, anyone who has had close contact with someone who has monkeypox is a concern.
The Centers for Disease Control and Prevention (CDC) is urging healthcare providers in the United States to be on the lookout for patients who seem to have rash diseases consistent with monkeypox, irrespective of whether they have travelled or have potential risk factors for monkeypox, and regardless of sexual orientation or gender identity.
There are no particular therapies for monkeypox virus infections. But genetic similarities between monkeypox and smallpox give an advantage in its treatment to find a possible cure. Antiviral medications and vaccines designed to guard against smallpox can be used for the prevention and treatment of the monkeypox virus. Tecovirimat (sold under the name TPOXX), an antiviral drug, can be prescribed for immune-compromised individuals, i.e. those more prone to get severely ill.
This drug was initially approved in US, UK, and Europe to cure smallpox. However, approvals from the European Medicines Agency (EMA) and the Norwegian Medicines Agency (NoMA) cover the treatment of monkeypox, cowpox, and side effects after vaccinia vaccination.
But, in what way does it combat such viruses? TPOXX stops the formation of viral envelopes needed for the maturation of the virus (variola or other poxviruses) to spread the infection from cell to cell. In addition, on May 30, 2022, the World Health Organization (WHO) certified that TPOXX is protective against monkeypox virus infection.
Multiple observational studies, according to WHO, have shown that smallpox vaccination is approximately 85 percent effective in preventing monkeypox. As of 2019, an attenuated monkeypox vaccine based on the Ankara strain (MVA) of the vaccinia virus has been approved by WHO. It is a two-dose vaccination with constrained availability. Vaccines based on the vaccinia virus generate cross-protection against orthopoxvirus, which is why smallpox and monkeypox vaccines are available.
In several countries, active camps are being set up to treat the monkeypox virus. However, a few clinical trials are being done on its vaccine. A Phase-3 clinical trial is being conducted in the Democratic Republic of the Congo involving 1600 participants, initiated on February 23, 2017.
The participants in this trial are the daily healthcare providers who are under constant exposure to the monkeypox virus. The primary objective of this clinical trial is to identify participants’ exposure to monkeypox and degree of illness, as well as to assess the efficacy and safety of the vaccine, IMVAMUNE (also named as MVA-BN, JYNNEOS, IMVANEX, and MVA).
Although it can pose a serious threat to humanity, it will have little impact on the rest of the world if managed properly. Besides, we have already learnt from our previous experiences and have become better at dealing with viral threats. Hence, adequate prevention measures and comprehensive treatment recommendations must be implemented to permanently eliminate the disease, both by the government and the public.
Reviewer:Manisha
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