Mpox: the next pandemic?

[island]

Mpox, the disease formerly known as monkeypox, has as of yesterday become a Public Health Emergency of International Concern. (For comparison, COVID-19 was declared a PHEIC on 30•JNR•20.)

An epidemic has been active in Africa for a while now with over 14,000 cases and 456 deaths. The first European case, in Sweden, was reported this week.

Mpox spreads by physical contact and enters the body through broken skin or holes such as the mouth. It can also be transmitted via small mammals.

The condition is tested for via PCR tests (remember those?) and whilst existing smallpox vaccines have some effect against it, they are not available at scale.

I am hopeful this will not turn into the next global pandemic of a similar type, but I would be lying if I said nobody should worry.

(Edit to add: this post is not copied from a source, it is my original writing based on a number of live/rolling news reports, posts on X, and research into the disease, combined with my personal opinions)

 

[joncombe]

I'll admit I'm pretty worried and stressed by it. Not by any risk of the disease but the Government reaction (or overreaction) to it. The BBC article (https://www.bbc.co.uk/news/articles/c4gqr5lrpwxo) ends with the statement "As other disease outbreaks have shown, swift international action can help stop the disease spreading further."

I found Covid lockdowns incredibly hard and the restrictions that lasted for years (remember "2 weeks to flatten the curve") and the constant Government lies. I am not sure I could go through that again. Last time it was the Conservatives in Government. I strongly disagree with what they did but I also recall Labour on the sidelines every time calling for more restrictions/longer restrictions/stricter restrictions.

In London with a London major, mask requirements continued on TFL transport for much longer than anywhere else. Similarly in Wales. In short Labour certainly appeared much keener on restrictions (despite now we can see the huge economic damage caused alongside the fact countries without severe restrictions, like Sweden, Iceland and some US states did not seem to suffer any worse than places that did).

Now we have a Labour government I am very worried they will impose restrictions against this - and probably very soon.

 

[brad465]

The methods of transmission are very different so I suspect it will be managed differently to covid, in good and bad ways.

What maybe worth adding is this: the human population in the last 100-200 years has exploded to 8 billion and encroachment on the rest of the environment has been prolific. In biology whenever one species comes to dominate an ecosystem, their predators and pathogens will grow in numbers and prevent that dominance prevailing. Humans may not have any natural predators, but there are plenty of fatal pathogens that exist and can both emerge and flourish while our population is where it is. Pandemics are therefore inevitable and while measures can be taken to reduce their shock impacts, it's stupid to think we can stop them in their tracks.

 

[joncombe]

The methods of transmission are very different so I suspect it will be managed differently to covid, in good and bad ways.

Is that true? Because the BBC article I linked above states. (https://www.bbc.co.uk/news/articles/c4gqr5lrpwxo)

Mpox, which was previously known as monkeypox, is transmitted through close contact, such as sex, skin-to-skin contact and talking or breathing close to another person.

It's the last part in bold that bothers me, because it sounds awfully familiar. I need a drink...

 

[adc82140]

We already have vaccines, we already have treatments. This isn't Covid mark 2. We have been vaccinatimg the vulnerable since 2022. It's not a problem in Europe. However this is a big problem for Africa, as Healthcare in the most part isn't as advanced. The action that Western countries should be taking is getting vaccines and treatments out to Africa at scale.

That BBC article is misleading, and they should be ashamed of themselves. Primary transmission is via sexual contact (of all types), and to a lesser extent by sharing bed linen and clothes. It can be transmitted by breathing and talking closely, but it really is close: think the Alex Ferguson hairdryer treatment, not routine conversation. Mpox is NOT an airborne disease.

The majority of cases have also been spread within the unsanitary conditions of the Congolese refugee camps.

There have been many hundreds of cases within the UK over the last couple of years and not one has resulted in a death.

The WHO has rightly declared this as a major concern in order to get the help to Africa to deal with this that those countries need.

 

[GRALISTAIR]

We already have vaccines, we already have treatments. This isn't Covid mark 2. We have been vaccinatimg the vulnerable since 2022. It's not a problem in Europe. However this is a big problem for Africa, as Healthcare in the most part isn't as advanced. The action that Western countries should be taking is getting vaccines and treatments out to Africa at scale.

That BBC article is misleading, and they should be ashamed of themselves. Primary transmission is via sexual contact (of all types), and to a lesser extent by sharing bed linen and clothes. It can be transmitted by breathing and talking closely, but it really is close: think the Alex Ferguson hairdryer treatment, not routine conversation. Mpox is NOT an airborne disease.

The majority of cases have also been spread within the unsanitary conditions of the Congolese refugee camps.

There have been many hundreds of cases within the UK over the last couple of years and not one has resulted in a death.

The WHO has rightly declared this as a major concern in order to get the help to Africa to deal with this that those countries need.

This seems a balanced reply without scaremongering.

 

[adc82140]

To add, anyone born before 1971 has already been vaccinated, so that covers a fair chunk of the vulnerable population.

The only echo of Covid I expect to see is a big vaccine push should things start to get a bit tricky.

 

[matthewjohnson]

Seems very convenient that a case of an African disease should suddenly appear in Europe less than 24 hours after a global health emergency is declared, or is it just me. Everything I've read on this suggests it shouldn't end up impacting and restricting our lives, but I don't trust governments not to overreact under media and screaming social media zealot pressure yet again.

Just hope I get my holiday in next week!

 

[adc82140]

Of course you will get your holiday next week. It's once again media over reporting. There have been over 300 cases in Sweden alone this year.

 

[Thirteen]

Contact tracing for mpox from the DRC and its surrounding countries is not going to be difficult especially since the Foreign Office advises against all but necessary travel to that region anyway. The case in Sweden is someone who recently visited the area.

Also, 14,000 cases and 456 deaths sounds like a lot but the population of Africa is 1.3bn, the DRC alone is 105m people so in terms of percentage, it's very low but the various African Health Systems could get overwhelmed hence the need for the WHO to declare an emergency in order to get treatment and vaccines produced ASAP.

 

[Busaholic]

There have been over 300 cases in Sweden alone this year.

Source please - I can't find any evidence of more than the one.

 

[dangie]

.... Last time it was the Conservatives in Government. I strongly disagree with what they did but I also recall Labour on the sidelines every time calling for more restrictions/longer restrictions/stricter restrictions....

I wouldn't put much store on that one. That's what the opposition do. Whatever the government implements, the opposition argues against it.

 

[oldman]

Source please - I can't find any evidence of more than the one.

The new case is of Clade (my new word for the day) 1 mpox. The informative BBC article referenced above mentions that there have been 300 cases of the less severe Clade 2 mpox in Sweden. There have been thousands of Clade 2 cases all over Europe.

 

[island]

Source please - I can't find any evidence of more than the one.

It says that in the Times today (print version only, page 4) but relates to a previous less severe strain rather than the current variant.

 

[Belperpete]

To add, anyone born before 1971 has already been vaccinated, so that covers a fair chunk of the vulnerable population.

As I understand it, vaccinated against smallpox, not mpox.. However, the vaccine should still give a reasonable level of protection against mpox.

There will be a lot of factors, such as how readily transmissible it is, how many of those who get it need hospitalisation, etc.

But the bottom line will be will it (or any other new virus) tip our health service over like COVID did. We do really need to act on the big lesson from COVID, that if we have a health system that is perpetually working on the knife edge, the more vulnerable we are. The Swedes managed much better, because they have significantly more doctors and hospital beds per head of population than we do. Anybody who has had to partake of Swedish healthcare, as I unfortunately have had to, will know that you can get seen by a doctor or dentist almost immediately, and the hospital experience is nothing like that in the UK.

 

[adc82140]

Short answer: no it won't tip the NHS over the edge. This is not the same as early Covid, that required high dependency care in hospital for many people. Mpox is still primarily a sexually transmitted disease, with a secondary transmission via close contact (ie households). You can't pick it up in Tesco. If you are unfortunate enough to pick it up, then it's bed rest at home, unless you are considered to be in the vulnerable category, in which case a vaccine should have been offered anyway. Ignore the quoted death rate from Congo. It's meaningless. HIV is rife there, as is malnourishment, so the population in general will be far more vulnerable.

 

[najaB]

I am hopeful this will not turn into the next global pandemic of a similar type, but I would be lying if I said nobody should worry.

Given the mode of transmission - generally requiring close physical contact - it's unlikely to go pandemic.

 

[island]

Given the mode of transmission - generally requiring close physical contact - it's unlikely to go pandemic.

Plenty of that happening this week at Wembley Stadium for the Taylor Swift concerts to give just one example.

 

[najaB]

Plenty of that happening this week at Wembley Stadium for the Taylor Swift concerts to give just one example.

I'll admit that I've never been to a big concert, but I'm lead to believe that the kind of contact which would transmit Mpox generally doesn't happen at the stadium, but occurs before or after the event in the hotels nearby.

 

[Belperpete]

The methods of transmission are very different so I suspect it will be managed differently to covid, in good and bad ways.

What maybe worth adding is this: the human population in the last 100-200 years has exploded to 8 billion and encroachment on the rest of the environment has been prolific. In biology whenever one species comes to dominate an ecosystem, their predators and pathogens will grow in numbers and prevent that dominance prevailing. Humans may not have any natural predators, but there are plenty of fatal pathogens that exist and can both emerge and flourish while our population is where it is. Pandemics are therefore inevitable and while measures can be taken to reduce their shock impacts, it's stupid to think we can stop them in their tracks.

Agreed, COVID wasn't the first pandemic, and it certainly won't be the last.

The world has changed dramatically in my lifetime. When I was young, foreign travel was only for the rich, nobody I knew as a child had ever been any further than a few select European destinations. It wasn't that long ago that China was virtually a closed country, the idea that masses of Chinese would be travelling on holiday all over the world would have been seen as fantastical. Apart perhaps from Egypt, mass travel to and from Africa is also relatively recent.

Looking at last night's Who Do You Think You Are, Vicky McClure's grandfather spent weeks on a boat going to fight in Malaya, and had he survived would likewise have spent weeks on a boat coming back. During that time, any virus would have played itself out on the boat. Nowadays you step on an airplane having just caught a virus, and step off before you would even test positive.

The question is not is there going to be another pandemic, but when. I am hoping that I might see out my days before the next one, as statistically I probably only have another decade or so left, but somehow I doubt it. The big issue is, will we be prepared for it? Sadly, again I doubt it.

I see little sign of any long-term will to significantly improve our health service, so that it is more resilient. And little consensus on how we should react to the next pandemic, so whatever the government of the day does, will be opposed by a significant proportion of the population. All that seems to be happening is that everyone is hoping this isn't the next one.....

 

[island]

I'll admit that I've never been to a big concert, but I'm lead to believe that the kind of contact which would transmit Mpox generally doesn't happen at the stadium, but occurs before or after the event in the hotels nearby.

You're led wrongly; the current strain of mpox is transmissible by normal touch as well as coughing and sneezing.

 

[Thirteen]

The World Health Organisation has been tracking this since January so 14,000 cases and 456 deaths over 8 months is 1750 cases per month and 57 deaths per month which while not great isn't cause for panic just caution.

The more I read into it, it sounds like the WHO wants developed countries to donate more vaccines and treatments. Africa needs 10 million as they only have 200,000. A rich country like Sweden for example can easily deal with mpox, the DRC and other places in Africa cannot.

 

[island]

The World Health Organisation has been tracking this since January so 14,000 cases and 456 deaths over 8 months is 1750 cases per month and 57 deaths per month which while not great isn't cause for panic just caution.

All that is true but the same or similar was the case on 01•FBY•20, two days after COVID was declared a PHEIC, was it not?

 

[najaB]

You're led wrongly; the current strain of mpox is transmissible by normal touch as well as coughing and sneezing.

As I understand it, only people with compromised immune systems are at risk of contracting it that way. Or those with prolonged contact:

Person-to-person transmission of mpox can occur through direct contact with infectious skin or other lesions such as in the mouth or on genitals; this includes contact which is

• face-to-face (talking or breathing)
• skin-to-skin (touching or vaginal/anal sex)
• mouth-to-mouth (kissing)
• mouth-to-skin contact (oral sex or kissing the skin)
• respiratory droplets or short-range aerosols from prolonged close contact

Source: https://www.who.int/news-room/fact-sheets/detail/monkeypox

 

[Thirteen]

All that is true but the same or similar was the case on 01•FBY•20, two days after COVID was declared a PHEIC, was it not?

mpox isn't a new disease though, this is the second time it's been a PHEIC since 2022.

You have to remember that Health care in Africa is poorer compared to other countries especially in places like the DRC where the living standards aren't exactly great.

 

[GRALISTAIR]

I wouldn't put much store on that one. That's what the opposition do. Whatever the government implements, the opposition argues against it.

Which is part of the problem in democracies imho.

 

[Busaholic]

All I can say at this stage is that I hope however it all pans out it doesn't lead to a special sub-section on this forum with dozens of separate threads.

 

[Belperpete]

As I understand it, only people with compromised immune systems are at risk of contracting it that way. Or those with prolonged contact:


Source: https://www.who.int/news-room/fact-sheets/detail/monkeypox

The source that you quoted also says:

Anyone can get mpox.

People can contract mpox from contaminated objects such as clothing or linens, through sharps injuries in health care, or in community setting such as tattoo parlours.

Obviously those with a compromised immune system are at greater risk of contracting it (and just about anything), but nowhere in that article can I see it saying that ONLY they are at risk of contracting it. Likewise the longer you spend in contact with an infected person, the greater the risk you have of contracting it, but nowhere in that article does it say that there is ONLY risk with prolonged contact.

 

[adc82140]

To reiterate though: no matter what the vectors of infection, this isn't Covid. We already have a stockpile of an effective vaccine, most people over the age of 53 will have partial immunity through their smallpox vaccine, and also you can be vaccinated as a defence even if you have already been infected.

I expect a big autumn push for vaccination amongst the vulnerable (immunosuppressed, health workers, sex workers etc)

Edit to add: the vaccine prevents even contracting the disease, so current travel guidance now recommends getting a shot before travelling to a high risk area. That recommendation could become compulsory for incoming persons from central Africa in my opinion.

 

[Thirteen]

To reiterate though: no matter what the vectors of infection, this isn't Covid. We already have a stockpile of an effective vaccine, most people over the age of 53 will have partial immunity through their smallpox vaccine, and also you can be vaccinated as a defence even if you have already been infected.

I expect a big autumn push for vaccination amongst the vulnerable (immunosuppressed, health workers, sex workers etc)

Edit to add: the vaccine prevents even contracting the disease, so current travel guidance now recommends getting a shot before travelling to a high risk area. That recommendation could become compulsory for incoming persons from central Africa in my opinion.

Travelling to places like the DRC and parts of Central Africa is a lot harder for the average Joe compare to say France. The Foreign Office's guidance was pretty strict even before the outbreak of mpox.

The healthcare system and general living conditions in those regions are pretty shocking.