Katharina Cavano l Palladium - Jul 11 2022
"No Need for Alarm", Says Palladium Epidemiologist as Cities Roll out Monkeypox Vaccines

At the end of June, the World Health Organization (WHO) emergency committee convened to discuss the multi-country monkeypox outbreak. And while the committee determined that the event doesn’t constitute a Public Health Emergency of International Concern, major cities are rolling out monkeypox vaccines and citizens are wondering if there’s another pandemic on the horizon.

For Dr Farley Cleghorn, Palladium Chief Medical Officer, monkeypox is not quite a reason to panic. “Mid-Coronavirus, the notion of global health security is paramount, and people are asking if it’s another COVID-19, but it’s not,” he asserts.

According to the WHO, monkeypox is a zoonosis, a disease that is transmitted from animals to humans and has similar, but less severe, symptoms to smallpox. Though smallpox was eradicated in 1980, monkeypox is still found in central and west Africa, until this year. “It has a host range that includes many mammals, unlike smallpox, which was restricted to humans.” The virus, which is often transmitted through contact with bodily fluids, makes human-to-human transmission difficult. But globally, the latest reports show over 5,700 confirmed cases in 49 countries outside of the African regions where it’s endemic, making the current outbreak the largest ever.

Cleghorn adds that the WHO committee convening was a good sign for global health security, with the intention to update guidance around the virus as it spreads and to assess its threat to global populations. “People and countries need and want guidance because we’ve never seen a large outbreak of monkeypox like this before.”

He says that this outbreak looks different than those in the past and the virus is actually presenting with more mild symptoms than the classic ‘textbook’ cases. Despite that, New York City is among one of the first to expand access to the vaccine and offering it to those who may be at higher risk of contracting it.

“Though monkeypox is highly infectious, it’s hard to contract it without close physical contact,” explains Cleghorn. “Unlike the COVID-19 vaccine, we combat monkeypox with ring vaccination where only those in close contact to someone with the virus receives the vaccine.”

“What we need to do to avoid the establishment of monkey pox as an endemic illness among already marginalised population groups, for example, men who have sex with men (MSM), a population which comprise the majority of monkeypox cases, is to rapidly improve surveillance, detection, and vaccination of contacts,” Cleghorn explains.

The WHO continues to monitor the situation and has announced that they will review their decision not to declare an emergency on an ongoing basis. Factors the committee will be keeping an eye on include increased hospitalisation or death rates, significant mutations, and increased growth rate in cases.

He adds that the pace of clinical suspicion and diagnosis, including the confirmation testing process through CDC, is too low and slow today, and in some cases taking upwards of 2 weeks for confirmation. “Some affected cases had to go through multiple contacts with the health system in order to be diagnosed.”

“It’s an emerging infectious disease threat,” says Cleghorn. “But is it in fact a threat? That’s the question we’ll be assessing. Because it’s so hard to transmit and it’s so mild, I don’t think it will be in general. The real threat is if it establishes itself as endemic among most vulnerable groups.”

And for those worrying that there might be a connection between COVID-19 and monkeypox, Cleghorn says it’s only circumstantial. “The only relationship between the two is the opening up of travel after all of the restrictions and more people moving around, creating the perfect conditions for more sustained spread.”

“There’s no need for alarm,” he adds. “If you feel that you have been in contact with a case of monkeypox, talk to your health care provider.”


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