What reporters should know about monkeypox

Oct 4, 2022 in Specialized Topics
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When outbreaks of Monkeypox emerged this summer in Europe and North America, concerns emerged of another pandemic similar to COVID-19. Following the World Health Organization's declaration of the monkeypox outbreak as "a public health emergency of international concern” in July, misinformation on the virus continued to grow.

To help debunk myths and misinformation about the monkeypox virus, ICFJ hosted Dr. Islam Hussein, a virologist and drug discovery researcher, in a webinar titled "Reporting on Monkeypox" through the ICFJ Pamela Howard Forum on Global Crisis Reporting. Here are some highlights and advice for journalists from the session:



Virus "spillover" 

Monkeypox is a "zoonotic disease," a term used to describe transmissible infections from animals to humans or through arthropods such as insects, spiders or crustaceans, explained Hussein. These kinds of diseases include COVID-19 and the HIV virus that causes AIDS.

Most viruses have developed their ability to perpetuate within one or a few host species. However, occasionally viruses undergo what Hussein referred to as "spillover": crossing the barrier to other species as made possible by mutations in the virus that enable it to infect new species. Hussein emphasized that various human activities disturb the natural ecology, including hunting and eating wild animals, deforestation, and climate change, which result in human populations living in closer proximity to wild animals and increasing the risk of virus spillover. 

Are we facing another COVID-19? 

Post-COVID-19 lockdown behavioral changes, in which people have largely abandoned masking and physical distancing, deteriorating immunity to novel viruses, as well as the rise in populations in close proximity to wild animals, are all potential contributing factors to the spread of monkeypox. However, according to Hussein, monkeypox does not transmit as quickly as COVID-19; hence, it is unlikely to cause another global pandemic. 

Unlike COVID-19, which spreads through tiny air-borne droplets called aerosols that can travel across short to medium distances, especially indoors, monkeypox spreads by very close and usually physical contact; this means a person with monkeypox would infect fewer people that they are in contact with compared to someone with COVID-19. 

Monkeypox  symptoms take longer than COVID-19 — up to 12 days to start — which gives doctors a window of at least five days after exposure to vaccinate an individual, which is not an option for COVID-19 patients who exhibit symptoms and can spread the disease shortly after being infected, said Hussein.

Transmissibility and mutations 

Monkeypox is not a new disease, having been present in humans since the 1970s in the Democratic Republic of the Congo. Previously, people typically caught monkeypox through close contact with infected animals, but today the virus can be transmitted via contact with either infected persons, animals or contaminated surfaces and items. The virus can also spread via inhalation of large respiratory droplets produced by sneezing or coughing, said Hussein. Poxviruses like monkeypox can also survive for  long periods outside the body, making surfaces including bedsheets and doorknobs potential vectors of transmission. Hussein added that, at this time, it is unclear whether mutations caused this virus to become more transmissible or allowed it to transmit via a new route.

According to Hussein, It is difficult to disentangle whether monkeypox is transmitted sexually or through skin-to-skin contact. When asked if monkeypox could be consider a sexually transmitted disease, Hussein’s response was, "maybe, but not exclusively." While monkeypox transmission has not previously been associated with sexual preference, sexual connections among men who have sex with men (MSM) played a significant role in this specific outbreak. 

Symptoms and complications

When the monkeypox virus enters the body, it starts to replicate and spread via the bloodstream. Symptoms such as skin rash take around one to three days to show on the face, then spread to other body parts; other symptoms such as fever and headaches, which enlarged lymph nodes, fatigue, and muscle aches usually do not appear until one or two weeks after infection. 

The risks for complications are higher among children, immunocompromised adults (including uncontrolled HIV, cancer, recent organ transplants, and certain autoimmune diseases), pregnant women (as the disease can infect the fetus and/or cause miscarriages), and people with certain skin conditions (such as eczema), said Hussein.

Vaccines and treatment

Mass vaccination does not seem to be crucial in the current circumstance; certain countries have used "ring vaccination," which contains the spread of the virus by offering vaccines to health care workers and close contacts with known cases, as a way of halting the spread.

Hussein explained that the "ring vaccination" method has some limitations, as it works best when infected people are identified promptly, close contacts are traced, and they are willing to take the shots. He added that the close similarity between monkeypox and Smallpox vaccines, which are stockpiled in some countries despite the disease being eradicated, makes Smallpox vaccines 85% effective against monkeypox. According to Hussein, there are currently three generations of smallpox vaccines: Vaccinia, ACAM2000 Vaccine and Modified Vaccinia Ankara (MVA), which have effectiveness against monkeypox.

Photo by CDC on Unsplash.