More than 3,500 confirmed or suspected cases of Monkeypox — a rare viral disease seldom detected outside of Africa — have been reported in 50 countries on 4 continents in the past month. The seemingly instantaneous emergence of the virus in random populations across the world has alarmed scientists and sent them racing for answers.
Monkeypox was first identified in 1958 among laboratory monkeys in Denmark but jumped to humans in the Democratic Republic of the Congo in 1970. The virus has been endemic or isolated in West Africa for 60 years, until now.
Symptoms begin with fever, headache, muscle pains, swollen lymph nodes and fatigue. It’s followed by a rash that blisters and crusts over. The incubation process is approximately 2-10 days, and symptoms typically last 2-4 weeks. A relative of smallpox, it spreads by an animal bite or scratch, from handling wild meat, contaminated objects, the exchange of bodily fluids or close contact with an infected person. The mortality rate is 5%
Appearing suddenly, in divergent regions around the world, suggests the virus may be spreading silently — a fact that Andrea McCollum, an epidemiologist who heads the US Centers for Disease Control and Prevention calls “deeply concerning.”
Another puzzle is why almost all of the case clusters include men aged 20–50, the majority of whom identify as LGBTQ. Although monkeypox isn’t known to be sexually transmitted, sexual activity certainly constitutes close contact, says Anne Rimoin, an epidemiologist at the University of California Los Angeles, who has studied monkeypox in the Democratic Republic of the Congo for more than a decade.
The most likely explanation for this unexpected pattern of transmission, MacIntyre adds, is that the virus was coincidentally introduced into the LGBTQ community and has continued circulating there.
The first news story on AIDS appeared on May 18, 1981 in the New York Native. AIDS was first clinically reported on June 5, 1981, with five cases in the United States. The initial cases were a cluster of gay men in New York City.
Hepatitis in Children
Another import from Africa, hepatitis has afflicted at least 176 children in the United Kingdom this year, and more than 500 worldwide.
At the center of the debate are conflicting theories about what is causing healthy young children to suddenly become jaundiced and fall seriously ill with acute liver inflammation. One hypothesis suggests the damage is being done by adenovirus, a common childhood infection that normally causes coldlike symptoms and could be treated with an antiviral drug.
Another hypothesis suggests an adenovirus infection forms a destructive partnership with SARS-CoV-2 that sets the immune system loose on the liver. However, the most pervasive theory suggests the surge of hepatitis in children is a rogue immune response to previous infection by SARS-CoV-2.
“It is profoundly embarrassing that major scientific bodies in U.S. and U.K. are using such weak circumstantial evidence to distract the public … from the likely possibility that recent SARS-CoV-2 infection may be driving the increase in cases,” says Farid Jalali, a hepatologist in Laguna Hills, California.
The outbreak of hepatitis in children, and monkeypox in gay men, is pointing to a consensus that COVID has been a co-actor, accelerating an often mild adenovirus into a more significant disease.
Monkey See, Monkey Do
Whether COVID is a facilitator for the outbreaks of monkeypox and hepatitis is as yet unsubstantiated. “But make no mistake,” says David Quammen, the American science and nature writer. “They’re connected.”
In “Spillover: Animal Infections and the Next Human Pandemic” Quammen writes. “Human-caused ecological pressures and disruptions are bringing animal pathogens ever more into contact with human populations, and human technology and behavior are spreading those pathogens ever more widely and quickly.”
We think we’re done with the pandemic, but the pandemic may not be done with us.