Here’s a story you might not know. In July 2015, a woman went to her doctor in Fairbanks, Alaska, concerned about several small bruises on her hands and pain in some muscles in her body. After some tests at a local hospital, it was determined that the woman was infected with an orthopoxvirus, a type of virus that causes most of the diseases historically called “pox.” What’s more, it was a never-before-seen virus, A novel orthopoxvirus which was named “Alaska Pox”.
The discovery of a novel virus in the same family as variola, the virus behind smallpox, which was responsible for 300 million deaths in the 20th century, was clearly alarming. However, over the next six years, the total number of Alaska pox cases increased to … four.
Alaska pox, as it turns out, cannot possibly be spread from person to person and is spread by contact with one of the Alaskans who seem to be involved in handling it. Seven years later, we’re still not sure what animal it could be. This is a good example of how a disease can be new, closely related to the deadliest disease in history, and still be essentially harmless. In this case, even small wounds caused by the disease heal well within a couple of weeks.
Smallpox is the biggest killer in the history of mankind. Alaska pox is a temporary inconvenience for some people. And, big surprise, most pox viruses fall somewhere in the middle, with most of them being very close to the Alaska pox pole that can infect people.
So what do we know about monkeypox?
As far as pox viruses go, monkeypox is really bad. It can cause very severe lesions anywhere on the body that leave the disfiguring scars that helped make the pox virus so virulent in the past. Those lesions can be painful. When they are in the eye area they can cause blindness. If you know someone with a bad case of shingles, think about it. Only worse. Between 1% and 4% of those infected, usually young children or adults with compromised immune systems, will die of the disease (and yes, that’s a wide range). While monkeypox can be serious, most cases of monkeypox are very mild – it can come and go with few symptoms.
It is absolutely true that monkeypox can be spread by respiratory droplets. It can also spread through respiratory droplets or contact with fluids from lesions left on surfaces, and the virus can remain viable on surfaces for periods of days. Maybe even weeks.
However … most of the warnings, and most of the information on that scary graphic that’s going around, don’t have much to do with how monkeypox actually spreads from person to person. Cautions about that image, and many of those relayed in the media, come from past experience dealing with monkey outbreaks among monkeys. Anyone who has read Richard Preston’s fascinating and terrifying book hot zone has some insight into how monkeys, especially those used in medical testing, are treated and housed, and when they start to spread out in angry, highly stressed, excrement rooms, So how hard can it be to include some really creepy bugs, urine spewing, bitey little primates that definitely didn’t want to be part of your damn experiment in the first place.
It should come as no surprise that health officials recommend more serious gear for entering a room with racks of sick monkeys than for your afternoon run to Save-A-Lot. do No Guess it’s time to switch from your N95 mask to something Dustin Hoffman might have worn. outbreak.
The biggest problem with monkeypox isn’t that it’s airborne, and it certainly isn’t sex—gay or otherwise. It’s just that monkeypox is mostly spread through contact, and the duration of infection is so long. In fact, a person can spread monkeypox as long as they have lesions, which can last for weeks. They may still be able to spread the disease a week or two after the previous dry and unsightly scab has cleared.
The number of known cases in the United States now is exactly the kind that can be handled by contact tracking and quarantine. The problem is the length of that quarantine. The length of symptoms averages around three weeks, but can last up to a few months. People who have been diagnosed with monkeypox should be isolated during the period after the last sore has cleared, with a good safety margin of 7 to 10 days. And every surface in the house needs a heavy duty bleach-y cleaning before it touches anything else.
The number of cases of monkeypox in America is also certainly at a level where local, state, and federal agencies can, and should, provide housing options for infected people so that they not only receive adequate treatment, but Can be safely isolated. Except in Florida, of course, where Gov. Ron DeSantis is surely drafting an executive order to include monkeypox patients in every classroom.
The fact that the number of cases in the US has doubled in the past week is cause for concern. Monkeypox can be fatal, it can be horrible even if it is not fatal, and children are one of the groups that suffer the most infections.
Here’s the good news:
1) You have an unusual chance of catching monkeypox through the air unless you actually encounter someone who is infected,
2) All types of orthopoxviruses are “non-dominant”.
These are DNA viruses, and most are very simple (variola viruses contain only 200 to 500 base pairs). This means that not only are specific vaccines 100% effective against monkeypox, but vaccines against any other pox virus are expected to be highly effective in preventing monkeypox. Compared to the 30,000-long RNA ladder of COVID-19, these viruses are much more stable, much easier to inhibit. A vaccine against orthopoxvirus not only prevents a serious infection, it also prevents an infection from starting.
This is, after all, how vaccination began in the first place. Back in 1796, English doctor Edward Jenner did an impressive piece of detective work. He realized that “skin like a milkmaid” was not just a saying, but that the young women working in the dairies actually had smooth skin, unblemished by the smallpox scars that were so common then. He combined this observation with the realization that lactating women often contracted the mild disease cowpox, which usually resulted in sores on the hands during their childhood. Jenner felt that this was apparently protecting them from smallpox outbreaks and deadly infections.
He then did what any good scientist would do when he didn’t have a handy room of caged monkeys: Jenner turned a 9-year-old boy into a test subject. The good doctor first took the material from the sore on the milkmaid’s hand, made a few scrapes on the arm of his gardener’s son, and rubbed it into that good old pie. Then he waited a few months, and deliberately exposed the child to smallpox. The boy did not develop smallpox.
However, most people today have not been vaccinated against smallpox. This is because the effectiveness of the smallpox vaccine, and the non-virulent nature of the virus, allowed us to make that bastard extinct. But smallpox vaccine is still available, so vaccination campaigns are possible, especially in areas where outbreaks are widespread.
There is also a vaccine developed specifically for monkeypox, Genios vaccine, 190,000 doses of which have been pulled from the Strategic National Stockpile to be administered to people close to known cases. There will certainly be a need for this vaccine, and more are coming, but the manufacturing rate is low because there isn’t much demand.
Monkeypox can also be treated with antiviral medications.
It is highly unlikely that monkeypox is going to explode into a nationwide epidemic, or even a global pandemic. Good evidence of this can be found in the fact that monkeypox is already endemic in many African countries, but it does not account for more than a few clusters of disease in any given year. There have been previous outbreaks, including in the UK and the US, but none of them were really massive. (A 71-case cluster in the United States in 2003 began with a girl who was bitten by a prairie dog. **Don’t mess with prairie dogs.)
When Covid-19 first appeared, it had a basic reproductive rate—that R0 Number—about 2.5. As each new and more infectious form has appeared, this number has continued to climb upward. R0 of the latest omicron variants is estimated to be a truly terrifying number somewhere above 18. COVID-19 may now be the most infectious disease we know of.
Monkeypox has an estimated Rs0 0.8 to 1.0. That means that on average, a person with monkeypox infects one other person. A r0 Such value means that the spread of a disease can almost certainly be stopped before it does—if officials practice good case tracing and people cooperate in effective quarantine.
Should you be worried? yes This is a perfectly reasonable answer. Should you be worried that the United States is about to see a second Covid-level pandemic before we get over the first? Also yes … but not monkeypox. It is clear that we will be living with Covid-19 for years or decades, as both individuals and governments have accepted that 200,000+ people are dying each year and millions are acquiring long-term disabilities. Enjoy a date night at Applebee’s.
We will face a new rapidly spreading disease where every passing day could mean millions of lives. Monkeypox it is not.
Wear a mask outside your home, more for covid-19 than monkeypox. Wash your hands. If you know some people in your area have been infected, keep this in mind and consider wearing disposable gloves or diligently using bleach-based wipes on things like that grocery cart handle. But don’t start shopping NASA Surplus for leftover lunar suits. Unless you just want one. Those things are cool.