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Mpox the misnomer -

If you’ve been keeping up with the news recently, you’ve probably heard of mpox or monkeypox. Despite its name, this rare infection has very little to do with monkeys.

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Monkeypox in Africa -

Given the name "monkeypox" because it was first discovered in monkeys in Denmark in 1958, the virus that causes this nasty infection is nowadays most commonly found in Central and West Africa.

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Global spread -

However, there have been a number of outbreaks since May 2022 in the US, UK, Australia, mainland Europe, and Canada. The World Health Organization has declared a global health emergency.

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From infection to symptoms - If you are infected with the virus that causes mpox, it normally takes between five and 21 days for the first symptoms to appear.

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The initial symptoms -

The initial symptoms of the infection include fever, headaches, muscle aches, swollen glands, exhaustion, and joint pain. Between one and five days after the onset of symptoms, a rash usually appears.

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The rash -

The rash is not dissimilar to that caused by chickenpox. It starts as raised bumps, which then turn into small fluid-filled blisters. These then eventually scab and fall off.

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Recovery -

The symptoms of mpox can be very nasty, but they usually clear up in a few weeks without treatment.

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Hospitalization -

However, some people experience more severe symptoms and become quite unwell. In these cases, hospital treatment is sometimes needed.

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Risk groups - The risk of needing hospital treatment is higher for older people, young children, and individuals taking medication that affects their immune system.

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Medical mystery -

The recent outbreak of monkeypox has puzzled health authorities and scientists. Until May 2022, the virus had been confined to Africa, and it is not clear why this has changed.

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The theory -

According to the existing research, it is likely that the mpox virus originates in rodents, and is then passed from animals to humans.

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African origins -

Genetic analysis has revealed that the variant of the virus causing the recent outbreaks belongs to a branch of the evolutionary tree that first appeared in West Africa.

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The complication -

However, there is no obvious link to any of the countries where the virus is currently endemic. In fact, experts suspect the virus was circulating outside Africa long before May 2022.

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Human-to-human transmission -

In terms of why it is spreading, further genetic analysis (although still preliminary) has shown that this variant of the mpox may have learnt to jump from human to human as early as 2017.

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Mutations -

Since then, it has likely undergone a high number of mutations that have allowed it to infect and spread more easily between humans.

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Mutations -

It may even have undergone a mutation that helps it inhibit some of our immune defenses.

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Mpox vs COVID-19 -

Although it is contagious, monkeypox is not as readily transmissible as COVID-19, which spreads rapidly via tiny droplets that we expel as we breathe.

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Close physical contact -

Mpox instead seems to spread by having close physical contact (usually prolonged) with someone who is infected.

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Expert opinion -

According to Madeline Barron from the American Society for Microbiology (ASM), "It could be contact with someone who has an infectious rash, such as lesions, scabs and bodily fluids.”

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Possible risk group -

A recent study published in the New England Journal of Medicine found that between April and June 2022, 98% of the infections in 16 countries were in men who have sex with men.

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Caveat -

It is not yet clear why this is. It may just be a coincidence; there is no evidence that the virus passes more quickly through this section of the population than any other.

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The most important factor -

Indeed, it is not yet clear that the virus can spread through sexual transmission routes. It seems to be close, intimate contact that is most important.

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How will the situation develop? -

Looking ahead, it seems reasonable that health authorities would be concerned about whether the mpox virus will evolve, that is to say, mutate into a more dangerous variant.

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Double strand DNA -

Without going into detail, the good news is that the mpox virus carries a double strand of DNA.

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Less likely to mutate -

Double strand DNA viruses are less likely to mutate than single stranded RNA (the virus that causes COVID-19, for example, is made from single stranded RNA).

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Global health emergency -

The World Health Organization nonetheless considers mpox to be a global health emergency, and this may be because of a virus we no longer hear much about: smallpox.

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The end of smallpox vaccinations -

The vaccines developed to protect people against smallpox are also effective against mpox. However, the smallpox vaccination campaign ended shortly after the world was declared smallpox-free in the 1980s.

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Lessened immunity -

This means that our immunity against mpox is not as high as it would have been if we had continued to vaccinate against smallpox.

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Going forward -

Since the outbreaks of mpox, governments have been replenishing their stocks of the smallpox vaccine (after a period of moving to destroy them).

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All in all -

Hopefully vaccination coupled with its relatively slow spread will help to contain mpox.

Sources: (BBC) (NHS)

See also: How do viruses jump from animals to humans?

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