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Should we be worried about monkeypox?

Monkeypox has received more attention than ever since it was designated a “public health emergency of international concern” by the World Health Organization (WHO) on July 23, the highest possible alert level. Should we be concerned about this? Here are five keys to understanding this disease, its effects, and the means used to stop its transmission.

1. What is monkeypox?

Monkeypox, also called “monkeypox”, is a disease caused by a virus of the same name. So named because it was first observed in 1958 in Denmark on captive monkeys.

However, this name is disputed, as monkeys have little to no involvement in the spread of the disease. On July 27, the City of New York asked the WHO to rename the disease, saying it feared its current name would particularly stigmatize the black population and prevent some people from seeking treatment.

There are two strains of monkeypox: Central African and West African. The cases reported so far in Quebec are associated with the second strain, which is good news: the West African strain is less dangerous than the Central African strain, its mortality rate is lower, and person-to-person transmission is weaker.

2. How is the disease transmitted and what are its symptoms?

Monkeypox can be transmitted in three ways: from person to person, through contaminated objects, or from animals to humans. The WHO specifies that person-to-person transmission occurs “through close contact with lesions, bodily fluids, respiratory droplets, and contaminated materials such as bedding.”

Early symptoms include fever, night sweats, headache, and joint or muscle pain. Then skin lesions appear, especially on the face, arms and legs. Symptoms last 2 to 4 weeks and the illness usually goes away on its own.

3. How many people got infected?

More than 18,000 cases of monkeypox have been reported worldwide as of July 27, according to the WHO. 78 countries are affected, but 70% of cases occur in Europe and 25% in the Americas. The organization also reports 5 deaths and says that about 1 in 10 of those infected was hospitalized to treat the pain caused by the disease.

Also as of July 27, there are 745 confirmed cases in Canada, including 346 in Quebec. The next day, the Montreal Regional Department of Public Health counted 299 cases in the metropolitan area.

Hugh Loemba, a virologist and professor at the University of Ottawa School of Medicine, said the WHO’s decision to raise the monkeypox alert level to the highest alert level is a call to action. “This should encourage the authorities of different countries to mobilize more financial, human and technical resources to contain the disease,” he says, referring to both prevention, screening and vaccination.

4. Who can get monkeypox?

In principle, anyone can get infected and spread the disease, but the vast majority of cases reported to date in Canada and elsewhere in the world involve men who report having had intimate sexual contact with other men.

However, monkeypox is not a sexually transmitted disease. According to current knowledge, transmission of infection occurs through close contact, and not through sexual contact. “The cases have been reported outside of the homosexual community, so they shouldn’t be stigmatized,” insists Dr. Loemba.

“This is not a disease that is dangerous for everyone. This is dangerous for some people. And it is these people at risk that we should focus on,” he adds.

5. Do we need to be vaccinated?

In Quebec, the monkeypox vaccine – 85% effective – is offered to people who have been in direct contact with skin, mucous membranes with lesions, or bodily fluids of an infected person, or contaminated objects such as clothing or bedding, within the past 14 days, but who have not yet developed symptoms of the disease.

The vaccine is also offered to men (cis or trans) who have or will have sex with another man (cis or trans) in Montreal, unless that is their only and regular sexual partner.

More than 13,000 people have been vaccinated in the Montreal area so far, but Montreal Regional Director of Public Health Dr. Mylène Drouin said July 28 that she hopes to vaccinate 25,000 people.

“We are not starting from scratch, as we did with COVID,” says Dr. Loemba, as a vaccine already exists, even if it is available in limited quantities. The task, in his opinion, is rather to challenge those who are at risk. “Information is not getting through,” he said. We need to communicate better about this disease.”

For more information, visit the WHO website (in French), the INSPQ vaccination guidelines, and the Government of Quebec website.

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