PM IAS JULY 25 EDITORIAL

A Recap of The Monkeypox Outbreak
GS Paper 2, Health, Infrastructure.
 

Context:

• Delhi confirmed its first case of Monkeypox, a day after the World Health Organization declared the infection a Public Health Emergency of International Concern.

What Is Monkeypox and What Causes It?

• It is a zoonotic virus that was discovered in monkeys in 1958 and can infect humans as well as other animals such as rodents and other primate species.
• Since the first human case was identified in 1970 in what is now the Democratic Republic of the Congo, the virus has become endemic in parts of Central and West Africa, owing primarily to zoonotic spill overs.
• The virus is in the same virus family as variola, the virus that causes smallpox. The virus has become endemic in parts of Central and West Africa since the first case of monkeypox in humans was identified in 1970 in the current Democratic Republic of the Congo.
• The designation of monkeypox as a PHEIC means that international efforts to contain the disease before it becomes a pandemic will be accelerated.
• This would imply encouraging countries to devise efforts to control transmission and coordinate resource sharing.
• The disease manifests symptoms similar to those seen in smallpox patients, but it is less contagious and less severe.

Symptoms of Monkey Pox:

• Monkeypox symptoms include fever, headache, muscle pain, and lethargy, as well as rashes and blisters on the face, palms, feet, mouth, eyes, or genitalia.
• These symptoms usually appear two weeks after infection but can last two to four weeks, with severe cases mostly occurring in children.
• Monkeypox is typically a self-limiting disease that resolves spontaneously without the need for treatment.
   

Who are at Risk?
New-borns, young children, and people with underlying immune deficiencies, on the other hand, may be at a higher risk of developing more severe symptoms.

Concerning Monkeypox:

• Monkeypox can be transferred through handling raw meat, an animal bite or scrape, bodily fluids, contaminated things, and/or close contact with an affected human. Normally, the virus infects certain rodents.
• To confirm the diagnosis, the virus’s DNA can be checked on a lesion. In appearance, the disease may mimic chickenpox.
• The smallpox vaccination is 85% effective in avoiding disease. Jynneos, an adult monkeypox immunisation, was approved in the United States in 2019.
• The current treatment regimen includes tecovirimat, an antiviral medication intended particularly to treat orthopoxvirus infections such as smallpox and monkeypox. It is approved for the treatment of monkeypox in the European Union and the United States.
• The Congo Basin (Central African) form of monkeypox has been reported to have a death rate of 10% to 11% if left untreated.

How Is the Virus Spread?

• The virus may spread from animals to people as well as between humans. Close contact with infected animals’ blood, secretions, or skin sores can result in viral transfer from animal to person.
• Human-to-human transmission might occur through personal contact, as well as through bodily fluids, skin sores, or contaminated products from sick persons.
• Close human contact during sexual activities is thought to be a cause of the disease’s current expansion, as indicated by its prevalence among gay, bisexual, and MSM populations.

What Distinguishes the Present Outbreak?

• Recently, in May 2022, many instances of monkeypox were recorded from areas where the illness was not endemic, and the majority of patients had a history of travel to Europe or North America rather than Africa.
• From late June to early July 2022, the number of confirmed monkeypox cases climbed by more than 70%, with Europe bearing the lion’s share of the burden.
• However, there is little known about the source and transmission channels of the 2022 outbreak, as well as the alterations in the virus that allowed it to infect people more frequently than previously, making monkeypox a disease of worldwide public health relevance.

What Exactly Does Designating Monkeypox a Public Health Emergency Entail?

• A Public Health Emergency Concern (PHEIC) is defined by the WHO as a disease outbreak that “poses a public health concern due to the worldwide transmission of illness” and may necessitate an immediate and coordinated international response.
• The WHO has issued seven PHEIC declarations since 2009, including the current COVID19 pandemic.
• This classification implies escalating worldwide efforts to limit the disease’s spread before it becomes a pandemic.
• Apart from increased contact tracing, diagnosis, and immunisation, this would imply encouraging governments to create strategies to restrict transmission and coordinate the sharing of critical resources such as vaccines and treatments.
• While research on the epidemiology, transmission pathways, and clinical manifestations of the illness is ongoing, the WHO will assist impacted countries in building an efficient outbreak response and surveillance, as well as preventative and treatment efforts against monkeypox.

There Are A Few Elements That Work in Favour:

• Due to the COVID19 pandemic, there is also availability of a rather effective vaccine, despite logistical challenges, as well as a widely available infrastructure for molecular diagnostics.
• The pathogen’s genomic monitoring offers a unique chance to trace interaction networks and assess the virus’s ongoing development.
• While it is encouraging that a considerable number of monkeypox genomes from the current epidemic are now available in the public domain, there is a huge differential in the numbers from poorer nations, particularly Asia, including India.

What Are the Current Monkeypox Preventative and Treatment Options?

• Monkeypox does not have any particular therapies. Clinical care of monkeypox involves symptom relief, management of complications, and prevention of long-term consequences.
• It is also unknown if prior monkeypox infection confers protective immunity against subsequent infections.
• However, because smallpox and monkeypox viruses have genetic similarities, vaccinations and antiviral medications used to eradicate smallpox can also protect against monkeypox.
• According to the WHO, smallpox vaccine is around 85% effective in preventing monkeypox, and so prior immunisation against smallpox may result in moderate illness.
• Although the original smallpox vaccinations are no longer available to the public, other vaccines have been produced, one of which was licenced for monkeypox prevention in 2019.
• Vaccination is being studied to determine its effectiveness and practicality in preventing monkeypox.
• While the world debates why Dr. Tedros declared monkeypox a global health emergency despite the committee voting against it almost a month ago, it may be time for the world to recognise that, with global warming, increasing human-wildlife conflicts around the world, and ubiquitous global travel, efforts for global public health cooperation and resource sharing have never been more important.
• As we emerge from a worldwide epidemic, there has never been a better opportunity to prepare for future threats.

Prevention:

The major preventative approach for monkeypox is to raise awareness of risk factors and educate individuals about the steps they may take to decrease their exposure to the virus.

• Lowering the possibility of human-to-human transfer.
• Reducing the possibility of zoonotic transmission.
• Preventing monkeypox through animal trade prohibitions.

The Way Forward:

• Improved surveillance and response, increased illness knowledge, and avoidance of contact with wild animals, particularly monkeys
• Any animals that have had contact with an infected animal should be confined, handled with caution, and monitored for monkeypox signs for 30 days.
• It is critical to redirect attention to other ailments. Since to Covid-19, there is a decrease in the number of reported instances of endemic illnesses because individuals are not seeking care in health institutions.