Where is monkeypox spreading fastest?

SINCE BRITAIN reported a case of monkeypox on May 7th, more than 100 infections have been found across the world. The disease, which is usually confined to Africa, is present in at least 14 countries in Europe and five elsewhere (not including Africa). The symptoms of infection are similar to those of smallpox: fever, exhaustion and pustules that spread across the face and body. The World Health Organisation (WHO) says the disease rarely kills healthy adults when treated early, but can be dangerous for children, pregnant women and immunocompromised people. In recent times it has been fatal in 3-6% of cases—a rate heightened by the poor health care in many African countries. A strain prevalent in Congo is much more likely to kill those infected than the west-African variant now spreading outside the continent. There is no recorded case of anyone outside of Africa having died of monkeypox.

Previous European outbreaks have been limited to recent travellers from Africa, or their close contacts. The first case found in Britain this month involved a person who had recently travelled from Nigeria. But since then the disease has spread more widely: Britain has diagnosed 57 people. Spain has reported 40 infections; Portugal 23. Some cases in America and Australia have been traced to travel in Europe or North America. Argentina, Austria and Denmark confirmed infections on May 23rd.

Monkeypox is most frequently transmitted through skin-to-skin contact, bodily fluids or contaminated material, such as clothes and bedding. Many of the recent infections in Europe have been linked to big events, including a gay-pride parade in Spain and a fetish festival in Belgium. Hans Kluge from the WHO has warned that “transmission could accelerate” during the summer months, fuelled by festivals and parties. He recommends thorough hand-washing and protective equipment for health workers. Infected people and their contacts have been advised to isolate for 21 days and health authorities are using contact-tracing to minimise the spread.

But the virus is not as rapidly transmissible as SARS-CoV-2. It does not mutate as quickly as influenza or coronaviruses, which means it is less likely suddenly to become more dangerous. And Western countries know how to deal with it. The last big outbreak outside Africa was in 2003, when monkeypox-carrying prairie dogs caused more than 70 cases in America. It was quickly contained. Vaccination can help people to recover even after they have been infected, and smallpox jabs (of which many countries have large stocks) are estimated to be 85% effective against monkeypox. Some countries are already “ring” vaccinating the personal contacts of those infected. Although, as in the early stages of the covid pandemic, cases will probably continue to rise, monkeypox is highly unlikely to lead to lockdowns.

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