Think back a few months, and while many of us were feeling more relaxed about Covid-19, another virus arrived that threatened to cause a new pandemic.
It was a potentially deadly virus that had traveled north from Africa, literally circled a dance floor in Europe, and then ricocheted around the world.
Australia saw its first case in May. In June, an Australian doctor said cases were rising on an “alarming trajectory”.
Some of those affected have detailed their symptoms and showed off their rashes on TikTok and TV shows. Social media became increasingly agitated as fears grew that they were spreading and potentially entering schools.
A group of doctors even went so far as to unilaterally proclaim it a “pandemic” and urged the World Health Organization to do the same.
This virus is, of course, monkeypox.
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Yet a few months later, cases of this smallpox-adjacent virus plummeted like a stone.
It’s an extraordinary, and perhaps unexpected, turnaround for a virus that many had predicted would ravage the population. And health watchers are still studying which measures may have had the most profound effect on the numbers.
This might turn out to be a case study in how to jump in and squash a developing disease.
The deputy coordinator of the White House Monkeypox Response Team, Dr. Demetre Daskalakis, told the Tim from New Yorkare that monkeypox has been so successfully stopped that it may soon be just a memory.
“Our goal is to eradicate; that’s what we’re working towards.
“The prediction is that we are going to get really close.”
But, a public health expert has warned, “monkey pox is not likely to go away anytime soon.” And there are fears that cases may start to rise again.
Dramatic turnaround
Globally, 68,000 people in 100 countries contracted monkeypox during the latest outbreak.
In the United States, which has recorded 25,000 infections, the highest in the world in this epidemic, cases peaked at 736 in a single day on August 22, according to the Centers for Disease Control and Prevention (CDC).
On September 28, only 107 new cases were diagnosed.
In New York, one of the epicenters of monkeypox in the United States, new cases are now one tenth of what they were about six weeks ago.
Australia has recorded 136 cases of monkeypox, with Victoria recording half. No one died. But last week it was revealed that Victoria had not seen a new case for weeks.
Chief Health Officer Professor Brett Sutton said it showed the spread of monkeypox had “reversed”.
This remarkable success – from Melbourne to Miami to Manchester – is believed to be due to two things: initial changes in behavior and then later protection against vaccinations.
Monkeypox is believed to have traveled from Central or West Africa, where some areas are endemic, to Europe and then spread around the world via two dance parties attended mainly by gay men.
The virus is mainly transmitted through skin contact, which can include sexual intercourse.
Fortunately, the virus circulating around the world appears to be relatively mild. Although there were 26 deaths and for a few it led to nasty complications such as kidney damage.
Working with the “successful” LGBTI community
The fact that the virus circulated within the LGBTI community may have had the effect of preventing – or at least delaying – it from spreading further.
It also meant that health messages could target a smaller group of people.
“There has been an enormous amount of public health education that has been provided, particularly to the MSM (men who have sex with men) community and the LBGTQ community which has been primarily impacted,” said William Schaffner, professor of preventive medicine at American Vanderbilt University.
“They were literally inundated with information about monkeypox and what you as an individual can do to protect yourself from infection,” he said. ABC News.
“A lot of the communication, I think, was successful. And I think people may have changed some of their behaviors, to reduce their risk.
There is data to support this supposition. A paper from the CDC, Emory University and Johns Hopkins Universitydetailed how in a survey of 824 sexually active gay men, half said they had reduced their sex since becoming aware of monkeypox.
“These data suggest that MSM are taking steps to protect themselves and their partners from monkeypox,” the journal says.
It has also made gay men – who have dealt with HIV for decades – particularly aware of their health, what to look out for and how to access medical services.
And a smaller group meant that monkeypox was not an abstract concept that affected others. Many homosexuals knew someone who had caught it.
14 times less likely to get monkeypox
This initial reduction in sexual activity provided time to intensify vaccination efforts. It took time. The primary vaccine is the Jynneos jab of which there was little immediately on hand.
However, production was sped up and more shots were taken from each vial by delivering it just under the skin rather than directly into the muscle as happened with the Covid shots.
Vaccination has also been prioritized for those most at risk of contracting monkeypox to create a wall of protection, called “ring vaccination”.
“It turned around thanks to the responsiveness and commitment (of the LGBTI community),” Dr Sutton said of the Australian outbreak.
“There you go, these pillars of a public health response are working. Case isolation, contact tracing and early detection through close engagement with the at-risk community.
There were concerns that the Jynneos jab, which was not designed specifically for this outbreak, might not be as effective as hoped.
However, CDC data released this week showed that people exposed to monkeypox who had not received the vaccine were 14 times more likely to contract the virus.
Monkeypox is still circulating
Nevertheless, some issue a warning.
“Although it is promising to see that the number of cases has come down, monkeypox is not expected to go away anytime soon,” public health professor Andrew Lee from Britain’s University of Sheffield wrote on a university website. The conversation.
Although the data on the effectiveness of the vaccine are promising, he postulated that it could be changes in sexual behavior that also played an important role in reducing cases.
If so, this poses a problem since asking sexually active people to give up on sex for long periods of time has never been a particularly effective strategy.
“The danger then is what happens when people’s behavior reverts to how it was before the current epidemic started. This could lead to a rebound in the number of infections,” Professor Lee said.
“We need to be careful not to stigmatize the disease, lest it go underground and make it harder for infected people to seek care.”
If monkeypox cases continue to drop, it will be a remarkable turnaround for a virus that some feared could be the new Covid. And it could be a model for how to deal with future epidemics.
However, as seen with the rollout of Covid-19 vaccinations, it is often people living in less wealthy countries who are left behind.
Monkeypox could disappear in the United States, United Kingdom and Australia. But if he stays in Africa, he can always become international again.
And next time around, the virus might find refuge in a less distinct group that might be much harder to target and communicate with and much less willing to engage and change their behaviors.
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