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Monkeypox outbreak: What we know so far

As many as 79 countries around the world have reported cases of the viral disease as of July 29. Out of these, only seven have a history of monkeypox outbreaks

August 02, 2022 / 12:49 PM IST

While India recorded the first death of a patient who had tested positive for monkeypox, more than 22,000 cases have been reported worldwide as of July 29, according to data compiled by the US Centers for Disease Control and Prevention (CDC).

The patient who died had recently come from the UAE and had tested positive there. Although he died after being infected by monkeypox, authorities haven’t yet confirmed whether the disease was the cause.

"Comparatively, the mortality rate of this disease is low. Therefore, we will examine why the 22-year-old man died as he had no other illness or health problems," Kerala Health Minister Veena George said, briefing the media on Sunday.

Other than the youth who died, India has reported four cases of the disease till now. Three were reported in Kerala, and one in Delhi. The case reported in Delhi stands out as the patient had no history of international travel.

So far, 79 countries across the world have reported the disease since January. Among these, only seven have historically reported monkeypox infections. Of the total number of cases, only 344 are from countries that have a history of outbreaks of the disease.

The World Health Organisation (WHO) declared the outbreak a global health emergency last month.

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This viral zoonotic disease that has primarily been reported in the tropical rainforest areas of central and west Africa, spreads from one person to another by close contact with lesions, body fluids, respiratory droplets, and contaminated materials such as bedding, according to the WHO.

Monkeypox, which has a clinical presentation similar to that of smallpox, is usually a self-contained disease. The symptoms–usually fever, rash and swollen lymph nodes–lasts for two to four weeks in most cases. According to the WHO, recent figures suggest the fatality rate of the disease to be around three to six percent, much lower than smallpox.

When it comes to demographics, data compiled by Global.health, a data science initiative, suggests that the median age of the infected is 41, and that almost all the patients are men. Out of all the recorded cases where the data on gender is available, 98 percent are described as male.

Based on less than 6 percent of the reported cases that had the sufficient metadata to be added in this figure. Source: Global.health Based on around 6 percent of the reported cases that had the sufficient metadata to be added in this figure. Source: Global.health

The basic reproduction number (denoted as R0) of a disease shows the number of new cases a single case can generate in a population that is fully susceptible to the disease. An R0 greater than 1 potentially means that there could be a surge in the number of infected.

The Omicron variant of Covid-19 is estimated to have an average basic reproduction number of 9.5.

For monkeypox, the figure is still debated. A study published by the WHO in 2020 showed the R0 to be 2.13. This figure is based on data collected from the Democratic Republic of the Congo between 1966–1984. However, estimates based on the current worldwide outbreak places the figure between 1.30 and 2.10.

Smallpox vaccinations have been shown to be 85 percent effective against monkeypox. But the original smallpox vaccinations are no longer available to the general public.

“There is little immunity to monkeypox among younger people living in non-endemic countries since the virus has not been present there,” said the WHO in a factsheet it published on the disease. Although newer smallpox vaccines have received approval from the WHO recently, they aren’t widely available yet.
Sreedev Krishnakumar
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