Mpox (termed monkeypox until 23 May 2022) is part of the Orthopoxviri- Virinae subfamily, which was previously known to induce symptoms similar to those caused by Smallpox virus. Nonetheless, the Mpox virus incurs less destructive symptoms in the human host; hence, Mpox is a viral zoonotic disease. Although the Mpox virus causes physical harm to humans, it is not contagious; this is distinctly different from other infectious entities such as cigarettes, trans-fat-containing foods, and sugary carbonated drinks that pose a great threat to health and wellness. However, Mpox is transmissible from one human to the other through direct contact and fomites, and it is of interest as it can cause cross-contamination in the operating theatre if we cannot control the infection. Therefore, we need to know and educate others on the nuances of Mpox in order to mitigate the potential for outbreaks of this infection.
The discovery of Mpox (previously known as monkeypox) has its roots in both animal and human cases, leading to its recognition as a distinct viral disease.
What is Mpox and How Does it Spread?
Discovery in Animals (1958):
Mpox was initially discovered in laboratory monkeys in 1958. In colonies of monkeys being kept for laboratory research in Copenhagen, Denmark, scientists observed the development of a pox-like disease. researchers isolated the agent causing the illness, ultimately naming the disease ‘monkeypox’.
First Human Case (1970):
Although Mpox was identified in monkeys earlier, it wasn’t until 1970 that the first human case was documented. This significant event involved a 9-month-old boy from the Congo, formerly known as Zaire. He was under examination as part of a rigorous smallpox eradication initiative. The symptoms he displayed—fever, a unique rash, and swollen lymph nodes—resembled those of smallpox. However, subsequent tests confirmed that the virus was distinct. This case represents the first known human infection with the Mpox virus, highlighting the need for ongoing vigilance and research into emerging infectious diseases.
Context of the Discovery::
During the 1970s, numerous African nations, including the Congo, faced the persistent threat of smallpox, a highly lethal disease. The global initiative aimed at eradicating smallpox necessitated rigorous surveillance and thorough investigations into illnesses resembling pox. It was in the course of these comprehensive efforts that Mpox was identified as a distinct disease. This highlights the importance of ongoing vigilance and research in the fight against infectious diseases.
Early Cases and Spread:
After the initial identification, additional cases of Mpox were reported, primarily in remote and forested regions of Central and West Africa. The virus was found to be zoonotic, meaning it could be transmitted from animals to humans. The primary animal reservoirs are believed to be various species of rodents and other small mammals, not monkeys as initially thought.
Human-to-human transmission was observed but was less efficient than transmission of smallpox. Most human cases were linked to direct contact with infected animals or their bodily fluids.
Public Health Implications:
The discovery of Mpox in humans raised concerns due to its similarities to smallpox, a virus that had caused global pandemics with high mortality rates. However, Mpox generally causes a less severe illness compared to smallpox, and the availability of the smallpox vaccine provided some cross-protection.
The disease has remained endemic in certain parts of Africa, with occasional outbreaks reported. In recent years, global travel and other factors have led to cases being identified outside Africa, prompting increased awareness and public health measures to prevent its spread.
Public Health Impact: COVID-19 has overwhelmed healthcare systems globally due to its high transmissibility, severe disease in a significant proportion of cases, and the strain it places on medical resources. Mpox, while serious, does not typically result in the same level of widespread healthcare strain.
Renaming of MonkeyPox to Mpox
- :The World Health Organization’s decision to rename “monkeypox” to “mpox” in November 2022 was influenced by several crucial factors that underscore the need for a more sensitive and accurate terminology. This change reflects a commitment to public health and cultural awareness, aiming to reduce stigma while fostering a more inclusive dialogue around the disease.
- The term “monkeypox” was associated with negative connotations and stigma, particularly toward African countries and communities, as the disease was often linked to Africa and primates. Stigmatizing names can lead to discrimination against certain groups of people and can affect public health efforts by discouraging individuals from seeking care or reporting cases.
- The name “monkeypox” could be misleading because the primary reservoirs of the virus are not monkeys but rather small mammals like rodents. The original name might suggest that monkeys are the main carriers, which is not accurate. Renaming the disease helps to clarify the source and nature of the virus, leading to better public understanding.
- The WHO and other health organizations have adopted guidelines that encourage the use of neutral, non-discriminatory, and non-stigmatizing names for diseases. These guidelines emphasize that names should not reference specific animals, geographic locations, or groups of people to avoid potential negative impacts.
- A clear and neutral name like “mpox” facilitates better communication across different languages and cultures. It helps in creating a unified and consistent response to the disease at a global level, which is critical for public health messaging, research, and policy-making.
- The decision to rename the disease also came after consultations with experts, stakeholders, and the general public. There was a growing consensus that the name “monkeypox” was problematic, and changing it would be beneficial for global health communication and efforts to control the disease.
Unprecedented Outbreaks in Non-Endemic Regions (2022-2023):
- :Historically, Mpox was largely confined to Central and West Africa, where it is considered endemic. However, starting in mid-2022, there was an unexpected surge of cases in countries outside Africa, including Europe, North America, and other regions where the disease was previously rare or unknown. This sudden spread to non-endemic areas raised alarms among global health authorities and the public.
- While Mpox had previously been associated primarily with zoonotic transmission (from animals to humans), the recent outbreaks showed a notable increase in human-to-human transmission, particularly through close contact. This includes direct contact with lesions, bodily fluids, respiratory droplets, and contaminated materials like bedding. The virus spread within communities, especially among certain social networks, leading to clusters of cases.
- The swift emergence of Mpox beyond its usual endemic areas triggered a crucial international public health response. In July 2022, the WHO designated the outbreak as a (PHEIC), underlining the gravity of the situation and catalyzing collaborative measures to curb its spread. This declaration not only heightened media coverage but also increased public awareness about the disease, emphasizing the urgent need for global vigilance and action.
- The rise in cases sparked discussions about the availability and deployment of vaccines and treatments. The smallpox vaccine, which offers some protection against Mpox, became a focal point, with countries initiating vaccination campaigns, particularly for high-risk populations. There was also increased interest in developing and distributing antiviral treatments for those infected.
- Enhanced surveillance and reporting have led to the identification of more cases than before, contributing to the perception of a growing problem. As countries became more vigilant, more cases were detected, reported, and shared publicly, further raising the profile of the disease.
- The spread of Mpox coincided with the ongoing COVID-19 pandemic, which has heightened public sensitivity to infectious diseases. Social media and news outlets played a significant role in amplifying concerns, leading to widespread public interest and discussion about the disease, its symptoms, and its transmission.
- The decision to rename the disease from “monkeypox” to “mpox” in late 2022 also contributed to its trending status. The renaming itself was a newsworthy event that drew attention to the disease, alongside ongoing discussions about public health, stigma, and global preparedness for infectious diseases.
- The unexpected global spread of Mpox has also fueled broader concerns about the potential for future pandemics. Public health experts and policymakers have emphasized the importance of preparing for emerging infectious diseases, with Mpox serving as a reminder of the vulnerabilities in global health systems.
The unexpected global spread in 2022-2023, particularly to non-endemic regions, underscored the need for vigilant public health measures, including enhanced surveillance, vaccination, and public awareness campaigns. The World Health Organization’s renaming of the disease to “Mpox” aimed to reduce stigma and improve global communication efforts.
In response to the outbreaks, international health organizations and governments have mobilized resources to control the spread, emphasizing the importance of vaccination, early detection, and treatment. While most cases remain mild, the potential for severe illness, particularly among vulnerable populations, highlights the ongoing need for global cooperation and preparedness.
In conclusion, Mpox serves as a critical reminder of the unpredictable nature of infectious diseases and the importance of global health vigilance. The lessons learned from the Mpox outbreaks will likely inform future strategies for managing and preventing emerging infectious diseases worldwide.
