JThe Centers for Disease Control and Prevention said on Friday that new genetic sequencing data indicates there are at least two separate outbreaks of monkeypox underway outside of Africa – a startling finding that an official says suggests that international spread is wider and occurring for longer than previously realized.
Three of the 10 viruses that the CDC has sequenced from recent cases of monkeypox in the United States – two from 2021 and eight from 2022 – are different from the viruses that have been sequenced by several countries involved in the large epidemic spreading in Europe and from Europe. This epidemic is currently driven by infections among gay, bisexual and other men who have sex with men.
While the three divergent viruses are clearly related to each other and share a common ancestor, they also differ more from each other than other viruses, Inger Damon, director of the High Consequence Pathogens and Pathologies Division, told STAT. from the CDC. .
Those infected in these three cases contracted the virus in a surprising geographic range of locations – one in Nigeria, one elsewhere in West Africa and the third in the Middle East or East Africa. This apparent wide spread of a related virus – which differs from the European epidemic strain – suggests that outbreaks of monkeypox outside countries where the virus is considered endemic may have simmered longer than expected, Damon acknowledged.
“I think that’s a very plausible explanation,” she said.
“What we think this indicates is that there are likely multiple introductions outside of Nigeria at recent times, and there are likely additional transmission events occurring around the world,” Damon said. .
“This begs the question … are there reservoirs and human infections occurring in a wider area? And I think that’s really a better understanding of the Middle East and East Africa as potential areas where the virus has been introduced.
Public health authorities have previously expressed concern that the spread of monkeypox can be stopped, with Hans Kluge, director of the World Health Organization’s European office, acknowledging earlier this week that it is currently unclear if the epidemic will be contained.
When asked if she thought the spread of monkeypox could be stopped, Damon evaded the question.
“Everyone is working very hard to try to understand what is going on and … to think about public health tools that can be used to prevent further spread, including sort of looking at the use of vaccines and the use of therapies, which are not unlimited. ,” she said. “I think it’s only with close monitoring and watching what’s going on that we’ll understand if this is something that can be contained.”
The CDC had previously uploaded four genetic sequences from 2022 U.S. cases to an internationally shared database. As of Thursday, 21 cases had been reported in 11 states since the current outbreak was revealed.
On Friday, the CDC uploaded four more footage from this year, plus two of independent introductions that occurred in 2021. These 2021 cases, detected in July and November, were people who had traveled to Nigeria and returned to Texas and Maryland, respectively.
All of the recent cases in the United States were infected with the West African monkeypox clade, which is also the clade responsible for the European outbreak. The West African clade causes a milder disease than the Congo Basin clade, which kills up to one in 10 people infected in the central African countries where it is found. The West African clade has a lower mortality rate, estimated at around 1%. No deaths have yet been reported among cases outside Africa this year.
Since mid-May, when UK health authorities alerted the world that monkeypox was spreading there, around 40 countries in Europe, the Americas, the Middle East and Australia have reported nearly 800 confirmed cases.
Damon said the other seven viruses the CDC has sequenced are very similar to viruses that European scientists have published. “These really cluster so closely together that we really think they’re all linked to the same outbreak,” she said.
Damon said the new findings suggest that healthcare professionals should think about monkeypox when dealing with patients who have unusual sores or what might appear to be a sexually transmitted infection.
“If you see an unusual rash or you see something that looks like a sexually transmitted disease to you, looks like syphilis, looks like herpes, we probably need to think about testing for monkeypox,” he said. she declared.
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