Questão 24 - FUNORTE Medicina 2022/2

Global monkeypox outbreak was "waiting to happen"

by Emily Craig

25/5/2022

 

    Eradicating smallpox may have left the world vulnerable to monkeypox, experts have warned amid growing fears about the current outbreak sweeping the world.

    Britons were routinely offered smallpox Jabs until the 1970s, when the scheme was deemed no longer necessary because the virus had been beaten into submission. Similar programmes were wound down across the world at the same time.

    Scientists say the waning immunity from the mammoth inoculation campaigns may help explain why monkeypox outbreaks are becoming more common across the world.

    Although not purposefully made for monkeypox, the Imvanex jab — made by Danish-based Bavarian Nordic — is up to 85 per cent effective because the two viruses are so similar. Antivirals and therapies for smallpox also work for monkeypox.

    Dr Romulus Breban, a researcher at the Pasteur Institute in Paris, said the current global outbreak was 'waiting to happen¹ because of the world's 'almost zero' immunity levei. Nineteen countries have detected cases in the past month, which has sparked alarm because infections usually only occur in west and central África.

    Professor Neil Mabbott, an immunopathologist from the University of Edinburgh, told MailOnline over-50s are the only group protected against monkeypox. 'Although the levei of immunity will wane in time, smallpox vaccination provides long-lasting protection,' he said. 'Some estimates suggest this may last for decades.'

    There are signs that monkeypox was becoming more common even before the latest outbreak, with studies in África suggesting the rates increased 20-fold between the 1980s and mid-2000s.

    Experts believe larger populations and more interaction with infected animais are behind the rise.

    At least 221 monkeypox cases have been confirmed across the world since the first patient was sickened in the UK on May 6, with most infections among gay and bisexual men. The United Arab Emirates, Czech Republic and Slovenia are the latest countries to log infections.

    The Czech man showed symptoms of the disease after returning from a festival in Antwerp, Belgium in early May. Several monkeypox cases have since been linked with Darklands-a large-scale fetish festival, held from May 5-8.

    The UK Health Security Agency is contacting high-risk contacts of confirmed cases and advising them to self-isolate at home for three weeks and avoid contact with children.

    They are also being offered the Imvanex vaccine.

    This strategy, known as ring vaccination, involves jabbing and monitoring anyone around an infected person to form a buffer of immune people to limit the spread of the disease.

    But the winding down of the campaign, which also kept monkeypox under control, has left unjabbed Britons exposed to the virus.

    As the proportion of the UK population with immunity against monkeypox has declined, it has theoretically given the virus room to circulate and be transmitted easier.

    Dr Breban told the Guardian: 'This outbreak was really waiting to happen. Our immunity levei is almost zero. People aged 50 and above are likely to be immune but the rest of us not, so we are very, very susceptible.'

    In a paper published in the journal Bulletin of the World Health Organization in September 2020, Dr Breban and colleagues warned monkeypox 'is an emerging infectious disease for which outbreak frequency and expected outbreak size in human populations have steadily increased'.

    The team pinpointed the spread of cases beyond west and central África as a pattern fuelled by the decline in immunity against orthopox viruses, a family of viruses that also includes smallpox and monkeypox, due to the end of the vaccination scheme.

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Source: Daily Mail (https://www.dailymail.co.uk/health/article-10849635/Global-monkeypox-outbreak-wa iting-happen-scientists-say.html)

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