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Is monkeypox the next COVID?

In the wake of the COVID-19 pandemic, public health experts are struggling to understand the unexpected spread of monkeypox in Massachusetts.

State officials have cooperated with the Centers for Disease Control and Prevention (CDC) to investigate the first case of monkeypox known to have reached the United States this year. Its carrier, a man who recently visited Canada, has been in isolation at a Boston hospital since May 12. The CDC confirmed on Wednesday that he was infected with the less severe West African strain of the virus.

Cases have been investigated in Canada, Australia and eight European countries.

From left to right: Alessandro Vespignani, Director of the Network Science Institute and Sternberg Family Distinguished Professor at Northeastern; Jared Auclair, associate dean of professional programs and graduate affairs, director of the Biopharmaceutical Analysis Training Laboratory and technical director of Northeastern’s Life Science Testing Center; and Brandon Dionne, Associate Clinical Professor in the Department of Pharmacy and Health Systems Science at Northeastern. Photos by Matthew Modoono and Adam Glanzman/Northeastern University

More than two years of COVID-19 have trained people to prepare for the next global health crisis. But Northeast experts say it’s entirely premature to compare this relatively small outbreak to the pandemic that has claimed more than 6 million lives.

“We’ve had monkeypox outbreaks in the past, most recently in 2003,” he says Brandon Dionne, an associate clinical professor in the Northeast Division of Pharmacy and Health Systems Science, regarding a US outbreak of more than 70 cases two decades ago. “His transmission is much, much lower than COVID. So it’s something to be aware of, but don’t panic at this point.”

If cases of monkeypox escalate to raise a greater level of concern, experts note that their symptoms will be more noticeable and the virus more treatable than SARS-CoV-2, the coronavirus that causes COVID-19 — particularly in the Early stages of the pandemic.

“I would describe the spread of cases as quite confusing in the sense that the situation is evolving by the hour,” he says Alessandro Vespignani, Director of the Network Science Institute and Sternberg Family Distinguished Professor at Northeastern. “The outbreak is quite large and we obviously need to understand what’s going on.”

The CDC describes Monkeypox as a “rare but potentially serious viral illness that typically begins with a flu-like illness and swelling of the lymph nodes and progresses to a widespread rash on the face and body.”

The virus was discovered in research monkeys in 1958 and first reported in a human in the Democratic Republic of the Congo in 1970. No human infections were reported for four decades before monkeypox reappeared in 2017. Fewer than 500 cases have been reported in the past five years – the vast majority of them in Nigeria.

The West African strain that infected the Boston patient is fatal in about 1% of patients. (Alternatively, the Congo Basin tribe has a 10% mortality rate.) The mortality rate from COVID-19 in the US is 1.2%, according to confirmed cases Johns Hopkins.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, testifies before the Senate Committee on Health, Education, Labor and Pensions on the response to the ongoing COVID-19 pandemic at the Dirksen Senate Office Building on Capitol Hill in Washington, DC.  Kent Nishimura/Los Angeles Times via Getty Images

The initial spread of cases to Portugal, the UK and Spain raised concerns that the virus was spreading more easily than before. However, Vespignani says that conclusions about increasing transmissions cannot be made without a clear understanding of patients’ medical histories, their communities, travel patterns and other factors.

It’s important not to overreact at this early stage, he says Jared AuclairDirector of Training laboratory for biopharmaceutical analysis in the Northeast.

“Due to COVID, we all have increased susceptibility to viruses right now,” says Auclair, who also serves as the technical lead for Northeastern’s Life Science Testing Center. “People should monitor symptoms and if they start getting lesions or smallpox then see a doctor. But in general it’s nothing to worry about.”

The CDC notes that the virus can be transmitted through respiratory droplets in confined spaces. It can also spread through contact with bodily fluids, monkeypox wounds, or objects (including clothing and bedding) that have been contaminated with fluids or wounds.

These sores can help identify carriers in the final stages of the disease, which Vespignani said could help limit the spread if contact tracing becomes necessary.

Most promising is that the existing smallpox vaccine is effective against monkeypox. Widespread smallpox vaccination was responsible for monkeypox dormant for more than 40 years, says Vespignani.

“Luckily we have the vaccine,” says Vespignani, although he notes that stocks are currently low.

According to the CDC, common household disinfectants are effective against monkeypox on surfaces.

Although monkeypox was first discovered in monkeys, the name of the virus is a misnomer, says Dionne.

“It actually comes from rodents and mainly in parts of Africa,” says Dionne. “What is unique at the moment is that we have seen it in people who have not traveled to the endemic areas. And that’s the question: How do we now see these types of outbreaks in people who haven’t traveled to a known area where they have cases?

“But overall,” he adds, “the risk of infection for each individual is still very low.”

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