In the wake of COVID-19, should we fear monkeypox? – Freedom

Dr Philippe Lagacé-Wiens. (photo: Marta Guerrero)

While the WHO estimates the total number of monkeypox cases worldwide at 50,000, Manitoba recorded its first case on August 19. In the wake of COVID-19, smallpox is less of a concern, but still worth watching.

By Hugo BEAUCAMP

Contrary to what its name might suggest, this disease does not come directly from monkeys. “Smallpox is so named because it was first discovered in Denmark in 1958 in captive monkeys. The original hosts of the virus are actually rodents,” explains Ibrahima Diallo, professor of microbiology at the University of Saint-Boniface.

“These African rodents constitute what is called a wild reservoir. These are animals that harbor a virus and are healthy carriers. The virus then uses them as a sort of nursery to multiply and, in case of contact with another animal or human, to spread. For these diseases, those which first develop in the animal kingdom before infecting humans, we speak of zoonoses.

Examples of zoonoses are not lacking, we could cite for example the Ebola virus, Dengue, Tapeworm, or even more recently, COVID-19. For Professor Diallo, zoonoses have become a real issue: “They have existed for millennia, but they were confined to the animal kingdom. Today, the human being went of himself in front of the danger by invading hitherto wild habitats. It is this rapprochement that has allowed these viruses to infect humans. »

Professor Ibrahima Diallo. (photo: Marta Guerrero)

Adding to this intensive farming practices, which are real disease laboratories, “I think we can expect to see other diseases emerge,” says Ibrahima Diallo. “Climate change also plays an important role in the spread of these diseases. Rising temperatures allow diseases endemic to certain hot regions of the world to acclimatize to other geographical areas. The same goes for animals. »

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| serious situation

The current situation, even if it is improving, is to be taken seriously. We are still far from what we experienced in 2019.

“The mode of transmission of monkeypox is much less efficient than that of the coronavirus”, assures Dr Philippe Lagacé-Wiens, specialist in medical microbiology and development of infectious diseases, “we do not yet know everything about the mode of transmission of this disease, but it seems that prolonged contact with the infected animal or person is necessary for the virus to spread. Outbreaks often take place within homes. »

The symptoms are many and varied, sometimes mild, sometimes more severe, even serious. Typically, monkeypox causes fever, muscle pain, back pain, loss of energy, and headache.

These symptoms are accompanied by rashes that can last between two to three weeks and can affect any area of ​​the body. The symptoms tend to disappear on their own, but it is possible to use so-called “supportive” care.

| No more vaccination obligation

While in countries where health systems are the most developed, the mortality rate is below 1%, Dr. Lagacé-Wiens explains, however, that the disease is not without risk: “The most severe cases are often observed in people who suffer from immunosuppressive diseases at the same time”, he adds that, “monkey pox is a disease which can cause, through its rashes, secondary infections. When the skin is open, it is more likely to be infected by bacteria such as staphylococcus. It also sometimes gives rise to itching in the mouth. In a situation where an individual is already suffering from malnutrition or starvation, it can have dire consequences. »

“Human” or “classic” smallpox is much more infectious and severe. On the other hand, according to the expert in medical microbiology, “their antigens are very similar, which means that the antibodies which protect against smallpox also protect very well against monkeypox. The solution therefore already exists, it is the vaccine.

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Compulsory until the disease was officially eradicated in 1979, the smallpox vaccine still exists and seems to be the best way to protect against monkeypox.

“It is the only virus that we have succeeded in eliminating completely thanks to immunization. Thus, if the decision was taken to no longer make the vaccine compulsory, it is because it was established that the risks involved in vaccination, however small, were greater than the risks of being infected with smallpox. »

Emerging or new diseases can sometimes share the same strain as diseases that are already known and for which a solution exists. It is therefore legitimate to ask whether it is not in our interest to continue to immunize ourselves against diseases that have disappeared or almost disappeared. To this, Dr. Lagacé-Wiens responds:

“We have witnessed during the pandemic the reluctance of part of the population to be vaccinated against a concrete threat. I think that preventive immunization against an epidemic that has not yet been identified would not be effective. It would have a cost, it would pose challenges and also, albeit very low, risks. »

| The stigmatized LGBTQ+ community

Finally, since the beginning of the spread of monkeypox, it has been associated with the LGBTQ+ community, more specifically with gay men.

As of September 2, the Government of Canada has 1,289 confirmed cases. As in other countries during this outbreak, the majority of cases in Canada so far are men who have reported having had intimate sexual contact with other men.

Stephen Hardy. (photo: Liberty Archives)

This corroborates a study published this summer by The New England Journal of Medicine which analyzed data from more than 520 cases in 16 countries (including Canada) over a two-month period between the end of April and the end of June. In total, 98% of the cases studied were gay or bisexual men.

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However, the professionals interviewed for this article would like to point out that this is not a sexually transmitted infection (STI) in the traditional sense of the term.

Indeed, according to the WHO (1), although the monkeypox virus has been detected in semen, it is not yet known whether the disease can be transmitted through semen or vaginal secretions. People with monkeypox are advised to use condoms for 12 weeks after recovery.

Also, using a condom will not protect against monkeypox, but it will help protect and protect others against several other STIs.

Finally, the WHO recalls that the virus is not transmitted only by sexual contact, but also by any form of close contact with an infected person. People living under the same roof are more at risk.

Despite this, the communication around this disease could be misinterpreted. So thinks Stephan Hardy, president of the Manitoba LGBTQ* collective. He fears stigmatizing fallout against the LGBT community.

“After decades of progress, I find it unfortunate how public health has gone about communicating about this disease. »

In this sense, the WHO also calls for the avoidance of any stigmatization against a community, for the obvious reasons of living together, but also to prevent the members of this community from feeling compelled to hide their illness. .

(1) Source WHO: https://www.who.int/fr/news-room/questions-and-answers/item/monkeypox


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