Monkeypox Is a Public Health Emergency | ‘It’s Nothing Like COVID’ Say Experts

Can the spread of monkeypox mean we're staring at another possible pandemic?

Monkeypox in India: Will we see another pandemic?

(Photo: iStock/FIT)

(This article was published on 22 July and is being republished in light of the World Health Organization (WHO) declaring the global monkeypox outbreak a public health emergency of international concern.)

India reported its Third case of Monkeypox on 22 July, just a few days after the country's first, prompting health authorities to get their guards up, and issue safety guidelines.

All three cases were detected in Kerala, and all three patients had recently travelled from the UAE.

An unexplained spike in cases of monkeypox in parts of the world has been on the radar of health authorities March 2022 — and the numbers just keep rising.

In such a situation, when the world is still reeling from one pandemic, the question arises, should we be bracing ourselves for another pandemic like situation?

A recent article authored by epidemiologist, and public health expert, Dr Chandrakant Lahariya that analyses the pandemic potential of monkeypox says we might not need to.

How does monkeypox compare to COVID-19? Should we be worried? Here's what experts are saying.

Monkeypox: 'We Know What We're Dealing With'

First, here's a quick run down of what we know about Monkeypox so far.

Monkeypox is a viral infection caused by the monkeypox virus and is typically spread by rodents and primates.

The good news is that it's not a new virus. Monkeypox has been around for a while now, and the virus is fairly familiar.

In fact, it has been an endemic in 11 countries in Western and Central Africa since the 1970s.

In the begining of 2022 though, something changed.

Cases of monkeypox started emerging in clusters in other countries, starting with the UK, and only one of these patients had a travel history to Africa.

Since then, nearly 1300 cases have been reported in over 42 countries.

Typical symptoms that patients are coming down with include:

• Fever

• Chills

• Headache

• Body ache

• Rashes

• Swollen lymph nodes

• Painful blisters on the hands, feet and face (like chickenpox)

Some experts say that the current outbreak isn't as unprecedented as it's being made out to be.

"I do not think it is 'suddenly' spreading now. We are hyper-aware because of the COVID-19 pandemic, so what would have been an 'inside page' story has become somewhat more prominent.

Dr Satyajit Rath, Immunologist, National Institute of Immunology to FIT

"I do not think that this is misplaced, but simply that the situation so far does not seem particularly novel," he added.

Speaking to FIT previously, Dr Vineeta Bal, an immunologist and scientist at IISER-Pune, also said, "I suspect hypersensitivity to infectious diseases of viral origin, especially zoonotic viral infections, is triggering panic buttons globally."

Although the WHO hasn't yet declared monkeypox a health emergency, it continues to keep a close watch on the situation.

Monkeypox vs COVID-19

Monkeypox vs COVID-19 how do they compare?

(Photo: iStock/Altered by FIT)

"It's very different from COVID," Dr Chandrakant Lahariya, epidemiologist, public health expert tells FIT.

"It is not a respiratory illness. It is a contact illness," He adds. What this means is that "it doesn't transmit unless there is a direct skin contact."

When monkeypox was first detected in the UK in March, many patients happened to be men who have sex with men (MSM) which prompted health authorities to consider the possibility of monkeypox being a sexually transmitted Infection.

"It isn't a sexually transmitted disease," says Dr Lahariya. Rather, he says, it is a disease that spreads through skin to skin contact, which means sexual activity increases the risk of getting infected.

• How it spreads

Another major point of difference that Dr Lahariya points out is that with Monkeypox, "unless the person is symptomatic, the person is not infectious."

"In SARS-CoV-2, if a person is asymptomatic, if they seem healthy, they can still transmit the virus to other people, that is the case with COVID. But not with monkeypox."

Dr Chandrakant Lahariya, Epidemiologist

"So even someone who comes into close contact with a (monkeypox) infected person will not get it unless the patient has symptoms," he adds.

• How fast it spreads

Because of the above reasons, monkeypox is usually a self-limited disease.

"It also has a longer incubation period of 6 to 13 days on average," says Dr Lahariya.

"So if you are exposed, you have ample time to isolate before you develop symptoms and become infectious," he added.

Speaking to FIT for a previous article, epidemiologist, Dr JP Muliyil also explained, "this (monkeypox) has a very low secondary attack rate. So you would need prolonged close contact before you are infected."

• How it mutates

According to the US Centres for Disease Control and Prevention, two strains of the monkeypox virus have been identified.

However, the strain that's going around "is a milder strain," and "has a low mortality," says Dr Lahariya.

• How severe it is

Although monkeypox can turn fatal, it doesn't happen often.

Of all the cases that have been reported outside of Africa since the beginning of the year, no deaths have been reported so far.

"That's the level of non-fatal condition of the virus. So there's nothing to worry," says Dr Lahariya.

Another Pandemic?

Can Monkeypox lead to another pandemic?

(Photo: FIT)

A disease outbreak doesn't necessarily have to lead to a pandemic.

A pandemic is declared when a disease or a virus has a widespread socio-economic impact, says Dr Lahariya, adding that in the case of monkeypox, "that is not going to happen."

"COVID had a large scale socio-economic impact which is why it was called a pandemic, monkeypox won't have a socio-economic impact."

Dr Chandrakant Lahariya, Epidemiologist

Moreover, we already have vaccines on standby if things get worse and it comes to that.

Smallpox vaccines are effective against monkeypox as well, and although the former were discontinued when smallpox was eradicated, countries still have reserves of the vaccine.

The original small pox vaccine were known to have brutal side effects. So, some companies have come out with newer, more tolerable vaccines for monkeypox.

India was also one of the last countries to stop giving out small pox vaccines, which means that the elderly in India, and those who were born up to the late 70s, are already vaccinated against monkeypox as well.

But, that doesn't mean we don't take it seriously.

Even if outbreaks like this one don't lead to a pandemic, Dr Lahariya says, "there is still a risk of a burden on the healthcare system."

This is the real problem, says Dr Satyajit Rath.

Speaking to FIT for a previous article he said that "our public health outreach systems are really not up to the task of efficient, deep, careful real-time surveillance of such diseases."

"And we do not seem to be planning realistically and adequately over the long term for correcting these deficiencies."

Dr Satyajit Rath, Immunologist, National Institute of Immunology to FIT