What is Monkeypox? Will Mpox become a global pandemic like Covid-19? Virologist Dr. Vinod Balasubramaniam explains

Monkeypox can be contained more effectively than COVID-19, says Virologist Dr. Vinod Balasubramaniam

As the world continues to battle new and emerging viral threats, one name has recently surfaced in public health discussions—monkeypox (now known as Mpox). With rising cases globally, many are concerned about whether Mpox could follow the devastating path of COVID-19. In an exclusive interview with Moneycontrol.com, Dr. Vinod Balasubramaniam, a molecular virologist and leader of the Infection and Immunity Research Strength at Monash University, provides critical insights into the nature of Mpox, its spread, and whether it has the potential to evolve into a global pandemic.

What is Monkeypox?

Dr. Balasubramaniam explains that Mpox is a zoonotic viral infection caused by the monkeypox virus (MPXV), a member of the Poxviridae family. It differs from smallpox and chickenpox in several ways. While smallpox has been eradicated and chickenpox is caused by a different virus, Mpox presents unique clinical features. "Monkeypox presents symptoms similar to smallpox, like fever and muscle aches, but is generally less severe," says Dr. Balasubramaniam. A key differentiating symptom of Mpox is lymphadenopathy, which is absent in smallpox. The characteristic rash also differs, as it primarily affects the face and extremities in Mpox, while smallpox and chickenpox rashes are more widespread.

How Does Monkeypox Spread?

Human-to-human transmission of Mpox has gained attention in recent outbreaks. Dr. Balasubramaniam highlights that Mpox is transmitted through close contact with infected individuals, primarily through skin lesions, mucosal surfaces, and respiratory droplets. Notably, recent outbreaks have shown a significant transmission route through sexual contact, especially among men who have sex with men. Mpox can also spread via contaminated surfaces or shared items like clothing and bedding. The incubation period ranges from 5 to 21 days, with most cases showing symptoms within 7 to 14 days.

Why the Sudden Rise in Cases?

The surge in Mpox cases since 2024 is attributed to several factors. A more virulent strain (clade I) has led to higher transmission rates and increased severity, with case fatality rates ranging from 1% to 10%. Dr. Balasubramaniam explains that another key factor is the waning immunity from smallpox vaccines, which ended decades ago, leaving younger populations more susceptible. Additionally, urbanization and increased rodent populations in endemic regions have contributed to the spread. There is also the possibility that mutations in the virus could be enhancing its transmissibility.

Are Vaccines Effective Against Monkeypox?

The JYNNEOS vaccine has shown significant effectiveness in preventing Mpox. Dr. Balasubramaniam cites studies showing that a two-dose regimen provides an estimated 66% effectiveness, while a single dose offers about 35.8% effectiveness. Vaccination is strongly recommended for high-risk groups, such as men who have sex with men, healthcare workers, and those recently exposed to the virus. "Vaccination plays a critical role in controlling the spread of Mpox and protecting vulnerable populations," emphasizes Dr. Balasubramaniam.

Preventing the Spread of Monkeypox

Dr. Balasubramaniam stresses that preventive measures are key to minimizing Mpox transmission, particularly in densely populated areas. Regular hand hygiene, wearing masks, and practicing safe sexual behaviors are important. Public awareness campaigns should educate communities on the symptoms and transmission routes of Mpox. High-risk individuals should also consider vaccination, while infected persons should isolate until lesions heal completely to prevent further spread.

Could Monkeypox Become a Global Pandemic?

While there are concerns about Mpox evolving into a global pandemic, Dr. Balasubramaniam believes that it can be contained more effectively than COVID-19. Unlike COVID-19, which spread rapidly through asymptomatic carriers, Mpox transmission requires close physical contact, allowing for more targeted public health interventions such as contact tracing and isolation. Additionally, vaccines like JYNNEOS and ACAM2000 have proven effective in preventing severe cases.

"While vigilance is crucial, the nature of Mpox transmission makes it easier to contain than COVID-19," Dr. Balasubramaniam states. Vaccination, isolation, and public awareness are key to preventing a larger outbreak.

How Prepared Are We for Monkeypox?

The global response to Mpox has been more proactive than the early days of the COVID-19 pandemic. Enhanced surveillance systems, targeted vaccination campaigns, and improved public awareness are helping control the spread. Countries like the US and UK have mobilized resources to vaccinate high-risk populations, and public health guidelines have been implemented to reduce transmission. Dr. Balasubramaniam believes that lessons from COVID-19, such as rapid containment measures and clear communication, are instrumental in managing Mpox effectively.

Applying Lessons from COVID-19

Dr. Balasubramaniam emphasizes the importance of applying lessons learned from COVID-19. Early containment measures, clear communication, and targeted vaccination strategies are crucial to preventing the uncontrolled spread of Mpox. Efficient contact tracing, public education, and global cooperation will be essential to managing future outbreaks.

Conclusion

While Mpox presents a serious public health concern, its transmission dynamics, coupled with the availability of effective vaccines and preventive measures, make it less likely to evolve into a global pandemic like COVID-19. However, Dr. Balasubramaniam warns that continued vigilance and proactive public health strategies are crucial in controlling the virus and protecting vulnerable populations.