The 21st century, that of epidemics?  'Scary dynamic' for monkeypox, not just an STD: 'Condoms don't prevent it'

The 21st century, that of epidemics? ‘Scary dynamic’ for monkeypox, not just an STD: ‘Condoms don’t prevent it’

What is there to be afraid of?

A risk reduction. At present, this epidemic does not seem to be of great danger because mortality is rare and the rate of hospitalization is low. But this is because it mainly affects young and healthy individuals, which are therefore unlikely to have complications. We fear an evolution similar to HIV, which was initially limited to the gay community and then very quickly affected the entire population. Especially since it is not a question here, I insist, of a sexually transmitted disease. The virus can be transmitted through any skin contact and also through contaminated items such as clothing.

It is also feared that the virus will find a “reservoir” animal in Europe, especially in rodents. Mice can, for example, be infected by dirty water, as we have seen with other viruses. It may be impossible to eradicate this virus in Europe.

If we do not control its spread, this virus will become endemic and we will face in Europe a new disease that will threaten us every day.“.

Can monkeypox be treated like a classic STD (sexually transmitted disease)?

No, it is very important to understand. It is sexually transmitted but not exclusively. Condoms do not stop transmission, for example, because they require intimate contact, but not necessarily intercourse. In addition, this is a virus that is more resistant than SARS-CoV-2, it can keep things going. So an infected person has a good chance of contaminating his relatives if he does not isolate himself.

What should be done?

It is not simple. WHO recommends testing and especially contact tracing. But due to the risk of stigmatization, under-reporting of cases is expected. We also know that vaccination alone is not enough. Because who will be vaccinated? All homosexuals? All caregivers? No one will try to impose that. And yet, in practice, we are not able to set up mass vaccination now because we only have a few thousand vaccine doses in Belgium, while hundreds of thousands are needed.

Personally, I am concerned that there is no unified attempt in Europe to more systematically trace contact cases or impose isolation. strictly of the sick. Obviously I can understand the reluctance on the part of the affected population, but it still raises questions about public health. If this infectious agent becomes endemic in Europe, it will represent a risk for everyone and may have high costs in the long term. In short, I know we are making the same mistakes as Covid, let it circulate the virus and then end up with “living with” as the only option. “

We haven’t seen an epidemic in a long time, and then, almost out of Covid, we are faced with a new threat. Is it possible to continue?

This is one of the obvious consequences of globalization, we are also globalizing pathogens. Currently, vaccination against “common” smallpox protects Africans against monkeypox. And until a few years ago, it was a population that was not well connected to the rest of the world. But we no longer vaccinate against smallpox and the connection to Africa is increasing.

All experts in eco-infectiology confirm that the 21st century will be epidemics, which are related to the interdependence of populations and especially climate change. We see the more frequent appearance of new pathogenic agents but also of resistance factors among the old ones. The WHO, for example, is very alert to resistance to antibiotics, which currently effectively protect us from many bacterial infections.

The price our societies will pay for this globalization of epidemics is likely to be very high in the long term. As we have seen with Covid, epidemics affect all aspects of our lives. It is very worrying that policy makers are not taking this seriously. Negotiations for an “international pandemic treaty”, which would be legally binding on the 194 member states of the WHO, began this year. But Europe should try to adopt a strong common health policy as soon as possible. This is important for the future.

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