By Dani Blum
The World Health Organization declared mpox a global health emergency last month. The virus, formerly known as monkeypox, is spreading quickly in parts of Africa, particularly Congo. The outbreak there has been fueled by a new version of the virus that has also been discovered in Sweden and Thailand.
The fast-evolving situation has led to anxiety and confusion about who is at risk of infection and how the virus spreads. “I can understand why there’s concern,” said Dr. Taimur Khan, associate medical research director at Fenway Health, a medical center in Boston. But, he added, “it’s not like we’re being caught off guard in the same way that we were with COVID-19. It’s a virus that we are familiar with, to a certain extent, and we have tools already.”
We asked Khan and other experts to answer common questions about the virus.
What are we learning about how mpox spreads?
As the virus has evolved, so has our understanding about how it circulates, said Dr. Rosamund Lewis, technical lead of the World Health Organization’s global mpox response team.
In the 2022 outbreak, many cases were caused by sexual contact. The newer version of the virus continues to spread through sex, but experts said it is also circulating in other ways. Those could potentially include skin-to-skin interactions, contact with infected animals and touching contaminated surfaces, objects or fabrics, such as bedding and clothes. Researchers are working to understand how the virus may spread through respiratory droplets and prolonged face-to-face interactions.
“We don’t always know exactly what was the mode of transmission in any given situation,” Lewis said.
Scientists are continuing to investigate when people are contagious. Some people can spread mpox days before they feel ill. No evidence to date indicates that people who never develop symptoms can spread the virus, according to the Centers for Disease Control and Prevention.
Who is most at risk?
The risk is greatest in countries in central and eastern Africa, especially Congo and bordering nations.
“The reality right now is the risk for Americans is exceedingly small,” said Dr. Carlos del Rio, an infectious disease specialist at Emory University.
Health care workers and people in the same household as someone with mpox are susceptible to infection. Because the virus spreads so efficiently through intimate contact, people with multiple sexual partners are at higher risk for contracting the virus.
Why do some people get more severe cases than others?
Mpox can cause painful rashes, fevers, head and muscle aches, swollen lymph nodes and other symptoms. Most people recover from mpox within a month, but the virus can be fatal. The version currently spreading in Africa appears to cause more severe illness, and be deadlier, than the version that spread in 2022.
Infants and children are at higher risk for getting seriously sick, in part because their immune systems are still developing. “Children become much more ill, much more quickly,” Lewis said. A majority of deaths in Congo have been among children younger than 15.
People who are immunocompromised, particularly those with untreated HIV, are also more likely to become seriously ill because their immune systems can’t fight off the virus effectively. Contracting the virus during pregnancy can lead to complications, including pregnancy loss.
What’s the situation in the United States?
The newer version of mpox spreading in Africa has not been detected yet in the United States. But people are still getting infected with the version that spread widely in 2022. Although American cases are currently lower than they were during that outbreak, there have still been over 1,700 cases nationwide this year — more than double the count at this time last year.
“People are still getting sick, and people are actually coming forward less to talk about their experience of getting sick, because it’s sort of fallen out of the public perception,” said Joseph Osmundson, a clinical associate professor of biology at New York University.
Who should get vaccinated? How long does the vaccine protect you?
Global health officials have raised concerns about gaps in vaccine access: Even though Congo is the epicenter of the current outbreak, for example, no vaccines are available there. The shots are more accessible in wealthy, Western countries.
“Our major role right now is honestly to try to keep the outbreak contained to Africa and send vaccines over there,” del Rio said.
But the renewed attention on mpox may also encourage eligible people in the United States to get vaccinated. The CDC recommends that some men who have sex with men, transgender people and nonbinary individuals get vaccinated, including those with multiple sexual partners or who have had sexually transmitted infections. People who know or suspect they were exposed to someone with mpox should also get vaccinated.
Experts said that some other groups may also want to get the shots, including women who have sex with bisexual men. “If you are in queer sexual networks, regardless of your identity, you are able to get vaccinated,” Osmundson said.
The CDC has an online directory people can use to find mpox vaccines near them. People should get two doses, at least 28 days apart; if someone has received only one shot, it is never too late for a second. Studies have shown that two doses of the vaccine can reduce the risk of infection between 66% and 88%.
Scientists are now studying how long that protection lasts. “We can’t promise that the vaccine will be effective forever,” said Dr. Kelly Johnson, an infectious disease specialist at the University of California, San Francisco. People can get mpox even if they’ve been vaccinated, she said, but those cases tend to be less severe. She compared mpox vaccines to COVID shots.
“There’s a good chance that if you do get COVID and you’re vaccinated, you’re not going to be one of those people who gets super sick,” she said. “I think it’s a very similar message with mpox.”
Σχόλια