Monkeypox Transmission

"Monkeypox is not HIV infection and won't have its consequences. It is self-limiting and, once infected, antibodies produced will likely prevent reinfection."

"It is not nearly as great a risk as COVID-19, with an ever-mutating virus that escapes the constraint of vaccination and has infected more than one billion people."

"It is however, yet another serious worldwide health concern that can further disrupt lives, the ability to work and further stress our crumbling health-care system. We have done too little too late to greatly dampen spread ."

"We now need to urgently vaccinate as many at-risk individuals as possible, act responsibly to avoid exposure, increase our testing capacity and pray that the disease burden will be manageable for our already overwhelmed health-care system."

Dr. Harry Rakowski, academic cardiologist and commentator, Toronto

A healthcare worker prepares to administer a monkeypox vaccine at the Pride Center in Wilton Manors, Fla., on July 12, 2022. Joe Raedle / Getty Images file

Monkeypox was known as a virus endemic to Africa at a low level of disease transmission. Until it was reported in Europe in mid-May with outbreaks in three countries where its appearance was linked to large social events where gay men have sex with multiple partners. This, according to a global study published recently in the New England Journal of Medicine.

 

On July 28 the Centers for Disease Control and Prevention in the United States reported on its website 21,000 cases in 75 countries where never before had a case of Monkeypox been seen. Globally, cases are rising now by roughly a thousand every day, a number certain to be an underestimate of the true burden of disease, reflecting a common enough phenomenon of under-reporting.

 

The vast proportion of cases -- about 99 percent -- occur in men typically who engage in sex with other men. The first case of Monkeypox was reported July 1 in Canada. By the time July 28 rolled around, 745 cases had been identified. The disease is spread through close physical contact with someone who is infected through sexual activity, mucous membrane transfer, or contact with fabrics such as clothing or bedsheets which were infected through use.

 

Although Monkeypox is basically a sexually transmitted disease, it can infect anyone at any age through skin contact with people who are infected or through the use of items the virus was transferred to, with use. How long the virus can remain viable on fabrics or surfaces is yet to be determined. It takes one to two weeks following exposure before the infected individual may develop fever and flu-like symptoms; headache, muscle aches and swollen lymph nodes.

 

In this combination image, participants carry a large Pride Flag at 2022 San Diego Pride Parade on July 16, 2022 in San Diego, California and right a stock image representing Monkeypox iStock / Getty Images

A pox-like rash then develops, characterized by pus-filled bumps (Pustules) that may resemble pimples or blisters. The disease is extremely uncomfortable for the sufferer, but few deaths result. The disease is known to be riskier for young children, pregnant women and older people. There are two vaccines approved by the FDA to be used in prevention.

 

The older of the two is available in large supply, originally developed for smallpox. The negative side of the ACAM vaccine is its significant side-effects which make it unsuitable for people with HIV; its use is not recommended for those with other immune diseases such as eczema or heart disease. The newer vaccine is available only in small supply.

 

A troubling aspect of the virus and its victimization of gay men with many sex partners being vulnerable to the disease is that venues that plan and stage events with high levels of sexual activity to the present -- Monkeypox spread aside -- decline to cancel those events. 

 

A line of people waiting for monkeypox vaccinations outside the Chelsea Sexual Health Clinic in Manhattan on Thursday.   Credit...Hiram Durán for The New York Times

African Zoonotic Mysterious Global Spread

"We are not facing a new disease that is akin to the coronavirus."

"We are not in a situation where very strong and widespread contagion will happen very quickly, but it remains serious and we have to contain it as quickly as possible."

"[We do not think it necessary to single out locations over fears of] stigmatization, [there are now measures in place]."

"The enemy is the virus, not the people affected."

Dr.Luc Boileau, interim public health director, Quebec

"Data have shown that if you give it [smallpox vaccine] within four days, you have a very good effectiveness in preventing the illness."

"If you administer it between Day 5 and 14, it might not prevent disease, but it might modify the evolution."

Dr.Caroline Quach, chair, immunization committee, Quebec

Electron microscope image   AP

 

Quebec is set to act in light of its thus-far having identified 25 cases of monkeypox virus in the Montreal area. The province has been provided with smallpox vaccine doses, Imvamune, from the federal government. Its decision is to meet the new challenge of yet another exotic virus by taking swift action on contagion prevention, planning to administer the vaccine to people beginning today, Friday. In addition to the 25 confirmed cases, another thirty suspected cases are under investigation.

The outbreak is considered to be serious, but the disease is considerably less transmissible than COVID-19 and the province hopes to eradicate the monkeypox virus in the province by an expeditious response to its presence. Officials plan to see that doses of Imvamune are administered to people who have experienced close contact with those infected, or who live with people who have assumed cases of the disease. Those who have active cases of monkeypox, on the other hand, will not be inoculated with the vaccine, since by then it would be too late to have an effect.

The vaccine Imvamune was approved in 2020 for the prevention of smallpox, along with other viruses that fall into the orthopox category and has been demonstrably effective in preventing monkeypox in animal studies. Ideally it should be given within four days of exposure, but it could still be administered up to two weeks following any exposure. According to Dr. Boileau, most monkeypox cases in the province have befallen adult men who had close sexual contact with other men who have the disease. One case was identified in a person under 18 years of age.

The symptoms primarily consist of skin lesions on the mouth and genitals. Fever and headaches as well as joint and muscle pain can also be present. Dr. Boileau advised that people who have suspected cases, along with anyone living with them, should isolate themselves. They should wear masks, cover their lesions and take care not to share clothing, bedding or eating utensils with others to avoid transmissibility. 

Direct contact with lesions represents the primary method of spread, although the virus can be transmitted as well by respiratory droplets. The Public Health Agency of Canada revealed that all confirmed cases of monkeypox in the country were detected in Quebec, to the present. Toronto public health authorities are investigating four suspected cases of the disease, including one linked to Montreal.

According to social media, Sauna G.I. Joe had hosted a sex party on May19, the very day that Canada confirmed its first case of monkeypox.