What to fear?
“An underestimation of the risk. At the moment, this epidemic does not seem to be very dangerous because mortality is very rare and the hospitalization rate is low. But this is because it mainly affects young, healthy people, so complications are unlikely. We can fear an evolution similar to that of HIV, which was initially limited to the gay community and then very quickly affected the entire population. Above all because here it is not, I insist, a disease that would only be transmitted through sexual contact. The virus can be transmitted through any skin contact and also through contaminated objects such as clothing.
It is also feared that the virus will find an animal “reservoir” in Europe, especially in rodents. Rats could, for example, become contaminated through sewage, as we have already seen with other viruses. Then it would be impossible to eradicate this virus in Europe.
If we fail to control its spread, this virus will become endemic and we will be faced in Europe with a new disease that will threaten us on a daily basis.“
Can monkeypox be treated like a classic STI (sexually transmitted infection)?
“No, it is very important to understand. It is transmitted sexually but not exclusively. A condom won’t stop its transmission, for example, because it requires close contact, but not necessarily sexual contact. In addition, it is a more resistant virus than SARS-CoV-2, it can persist on objects. Therefore, an infected individual has a good chance of contaminating their relatives if they do not isolate themselves.“
What should be done?
“It’s not easy. The WHO has recommended testing and especially tracing contact cases. But due to the risk of stigmatization, underreporting of cases is expected. We also know that vaccination alone will not be enough. Because who to vaccinate? All homosexuals? All caregivers? No one is going to try to impose that. And anyway, in practice today we cannot establish mass vaccination because we only have a few thousand doses of vaccine in Belgium, while hundreds of thousands are needed to protect all people at risk.
I personally find it worrying that there is no concerted attempt in Europe to more systematically trace contact cases or enforce isolation. strict to the sick Obviously I can understand the reluctance in view of the affected populations, but it still raises questions in terms of public health. If this infectious agent becomes endemic in Europe, it will pose a risk to everyone and could have a significant long-term cost. In short, I find that we make the same mistakes as with the Covid, let it circulate the virus and then end up with ‘living with it’ as the only option.”
It had been a long time since we had seen an epidemic, and then, just after Covid, we faced a new threat. Is this likely to continue?
“This is one of the obvious consequences of globalization, you are also globalizing pathogens. Until now, vaccination against ‘common’ smallpox has protected Africans against monkeypox. And until a few years ago, it was a population that still it was poorly connected with the rest of the world, but we no longer vaccinate against smallpox and the interconnection with Africa is increasing.
All experts in ecoinfectiology affirm that the 21st century will be the century of epidemics, in relation to the interconnection of populations and especially climate change. We see the increasingly frequent appearance of new pathogens but also of resistance factors among the old ones. The WHO, for example, is very attentive to resistance to antibiotics, which have so far effectively protected us from many bacterial infections.
The price our societies pay for this globalization of epidemics is likely to be very high in the long run. As we have seen with Covid, epidemics affect all aspects of our existence. It is very worrying that policy makers are not taking this more 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. It is essential for the future.”
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