Monkeypox: Four Scenarios, According to Scientists

as cases of monkeypox continue to seep into various countries around the world, scientists consider the most likely scenarios. While fears of another pandemic are legitimate, experts consulted by EL PAÍS consider it “highly unlikely”; in any case, they say, it would have very different characteristics from Covid-19.

Here are the four scenarios projected by our experts, ranked from most to least likely:

Outbreak contained within a few weeks

Óscar Zurriaga, from the Spanish Society of Epidemiologyand Raúl Rivas González, Professor of Microbiology and Genetics at the University of Salamanca, believe that the containment measures taken – detection and isolation of cases – should be enough to stop the virus.

From what is known so far, the pathogen is transmitted through fluids. Therefore, contamination can only occur through close contact with another infected person (or animal).

While the number of cases where there is an outbreak continues to rise at the moment, Rivas González says it will likely end between six and eight weeks after it started.

There are still several unknowns who only keep this scenario hypothetical. Airborne transmission of the virus has not been completely ruled out, as cases can be difficult to trace and occur in people who do not appear to have been in close contact with other infected people.

Containment with ring vaccination

“I think ring vaccination should start now,” says immunologist and researcher Matilde Cañelles, referring to the practice of immunizing people who have been in contact with infected people, along with their close contacts. France and the United States have already started ring vaccination with the drug against smallpox, the only human disease that has been eradicated. The smallpox vaccine is believed to provide more than 70% protection against monkeypox, and includes people of older generations who had the smallpox vaccine as children.

Rivas González also proposes to vaccinate health workers, who may come into contact with the virus in their work. Meanwhile, Zurriaga doesn’t rule out the need for mass vaccination at some point: [Salto de ajuste de texto]”I don’t think it’s the right thing to do, but if one country does it, I wouldn’t be surprised if others got behind it for more political than scientific reasons.”

The parties consulted agree that vaccinations should be sufficient to make the virus disappear. But it is also not guaranteed.

The virus becomes endemic

One of the biggest fears of health authorities is that the virus will become endemic in Europe, as it already is in some African countries. This would mean that outbreaks would be relatively frequent, either because the infection in humans is not stopped or because it reaches animals, whose virus has repeatedly jumped to humans. “That’s why isolation from the infected is very important, as well as from their pets,” says Rivas González.

“And if the virus comes into contact with other animals, it will be much harder to fight.” That’s why it’s so important to find out the origin of this outbreak, the scientist adds.

An “almost impossible” pandemic

“A pandemic is very unlikely, I would say almost impossible,” says Rivas González, while Zurriaga says it is “very unlikely”.

Cañelles does not see it as a likely scenario either, but she is cautious: “We cannot completely rule out transmission by aerosols, as has happened with Covid.” If monkeypox was confirmed to be airborne, a pandemic would be more likely.

José Jiménez, an emerging virus researcher at the Department of Infectious Diseases at King’s College London says, “There are still too many things we don’t know about the current outbreak.”

“If there’s one thing we should have learned by now, it’s that viruses can always surprise us,” he adds.

comparisons with covid are unavoidable, but even if monkeypox were to become a pandemic, Jiménez points out that there are many differences between the two viruses, noting that SARS-CoV-2 was completely unknown and that there were no vaccines or drugs against it — while there were none. particulars are for monkeypox, the vaccines used against smallpox seem to be quite effective. It is also a virus that has been known for half a century, causes frequent outbreaks in Africa and has a much more stable structure than that of the pathogen that causes Covid.

As Cañelles puts it, “We have the tools to stop it.”

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