With the increasing spread of monkeypox cases, the World Health Organization (WHO) recently declared the disease a global health emergency. With four monkeypox cases, including one (in Delhi) with no travel history, India has come to be alerted, and government advisories for strict monitoring have been issued. At this moment, it is necessary to have awareness about the virus and take precautions against the disease.
At this preliminary stage of the monkeypox infection in India, the first question is should we worry about a possible spread of transmissions in the country. This will again depend upon the genetics and the biology of the virus.
Professor Satyajit Rath, an eminent immunologist and adjunct faculty at the Indian Institute of Science Education and Research (IISER), spoke to Newsclick, explaining the facts associated with the virus and its spread. He said, “There is only anecdotal evidence of one or two cases of human-to-human transmission in India so far. So, I would not label this ‘community transmission’ as we have seen with, say, COVID-19.”
On the spread pattern of the monkeypox virus, Prof. Rath said, “The pattern of spread seems to be similar to the outbreaks that African countries have been seeing for years now – that very close contact leads to transmission. Most of what is being seen outside Africa seems to be the West African lineage of the virus, which usually causes somewhat milder illness than the Central African lineage.”
“Since this is a DNA virus, mutation rates are lower than in, say, SARS-CoV-2. It is not a highly lethal virus, and severe illness seems to be associated with young children and immunocompromised people, especially HIV-infected people,” Rath said further.
Monkeypox was first detected in 1958 amongst laboratory monkeys and has been named as such. However, monkeys have little to do with the spread of the virus causing the disease. The virus is thought to spread from wild sources like rodents to people and from one infected person to another. Usually, a few thousand disease cases are reported annually in Western and Central Africa. Cases outside Africa have been limited, and such cases are mostly from travelers to Africa and imports of infected animals. The total recorded cases outside of Africa since 1970, when the virus was first detected in the human body, have already been surpassed by the number of cases in recent weeks.
Precautions and awareness are essential to stall the spread of the virus. Prof. Rath said, “Awareness is important; avoiding close contact with people with rashes and pox is important (though transmission can happen before the rash appears), reporting illness is important so as to allow contact tracing.”
Currently, the virus has spread to over 75 countries infecting over 16,000 people globally. The human-to-human transmission of the virus mainly takes place via respiratory droplets and close skin contact with lesions. This limits the spread of the virus in comparison to SARS-CoV-2, which causes COVID-19. Moreover, as the virus is related to smallpox, we have vaccines on hand and antivirals. However, in a statement on Monday, the Indian Health Ministry officials said that as of now, there are no plans to procure the smallpox vaccines for India.
On the measures taken to tackle the monkeypox virus, Prof. Rath said that at this preliminary stage of the disease, the country seems to be on the right track by and large. “However, it is not clear if the government has made provisions for a ‘ring vaccination’ strategy, and where the vaccine doses needed will come from,” he added.