Monkeypox virus spreads to multiple countries amid struggle to contain COVID-19

Questions are swirling around an apparent outbreak of monkeypox, a rare disease that has been found in a number of countries around the world including the U.S. In light of the pandemic, many are asking about what they need to know. Dr. Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine, joins John Yang to discuss.

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  • Judy Woodruff:

    Now let's look at questions around monkeypox, a rare illness that has been found in a number of countries around the world, including the U.S.

    In light of the coronavirus pandemic, many are asking questions about what they need to know.

    John Yang gets some answers.

  • John Yang:

    Judy, worldwide, there have been roughly 200 confirmed and suspected cases in at least a dozen countries.

    In the United States, the first case was identified last week in a Massachusetts patient who had recently been in Canada. There is a small number of presumed, though not yet confirmed, cases in New York City, Florida and Utah.

    Dr. Peter Hotez is dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, Texas.

    Dr. Hotez, thanks so much for being with us.

    Let's start off with the basics. What is monkeypox, what are its symptoms, and how is it transmitted? How is it spread?

    Dr. Peter Hotez, Baylor College of Medicine: Well, monkeypox is — belongs to a family of viruses known as orthopoxviruses, actually similar to smallpox, but much less severe in terms of human disease.

    It — it's transmitted by close physical contact or through droplets or potentially respiratory contact, usually intimate contact, produces less severe disease than smallpox. It begins with fever, backache, headache. And then one of the distinguishing features is lots of swollen lymph nodes, particularly around the head and neck, but also elsewhere in the body.

    And then, a day or two later, it's associated with a characteristic rash, first of this vesicular rash similar to chicken pox, and then it becomes pustules after that.

  • John Yang:

    You say close contact and droplets. It sounds a little bit like COVID?

  • Dr. Peter Hotez:

    Not — well, it's actually much more difficult to transmit than COVID.

    So, COVID is an aerosolized virus. You can have some degree of aerosolization with monkeypox, but it's primarily through very close, intimate, face-to-face contact. So, in this case, we're seeing high rates of infection, higher rates of infection among gay and bisexual men, but not through sexual transmission, we don't think.

    Rather, it's that other intimate skin-to-skin or other intimate contact, but not through conventional sexual transmission.

  • John Yang:

    What else do we know about this outbreak? And how concerned should Americans be about it?

  • Dr. Peter Hotez:

    Well, I think it's important to keep in mind the numbers, as you pointed out, around 200 cases. Now it's up to around 250 cases, about half of them in Spain and Portugal, both suspected and confirmed cases, then the U.K.

    We're talking about 20, 25 cases in Canada, four or five cases confirmed or suspected in the United States. Those numbers will grow. But it's unlikely that we're going to be talking anything close to what we have seen with COVID-19.

    And there's a lot of good news to think about. One is, it's not nearly as transmissible. You have a much longer incubation period, maybe up to two weeks. That gives you time to investigate the contacts. You can trace the contacts, because, if you have the infection, you have a characteristic, vesicular or postural rash.

    And because the vaccines and drugs used to treat or prevent smallpox also cross-protect or treat monkeypox, the U.S. government for the last 20 years since the founding of BARDA has been stockpiling vaccines for smallpox and antiviral drugs. So, if the numbers do start to increase, and we have to vaccinate populations at risk, we can move on that pretty quickly.

    So, for all of those reasons, we're not looking at anything near the magnitude or the concern of something like COVID-19.

  • John Yang:

    How unusual is this outbreak, though? It's not usually seen in the United States.

  • Dr. Peter Hotez:

    That's right.

    And I think the unusual piece to this is the fact that it's been multiple foci in European countries, particularly in Southern Europe, in the U.K., but also in Germany and Belgium and elsewhere, and now North America.

    I think that's the really striking part. And just by coincidence, it probably became — an individual in the gay or bisexual community became infected and then, according to the World Health Organization, potentially passed it on through sexual networks. And that seems to be where it's spreading.

    But we don't have a lot of details. So we're not — it's not as if those 250 cases we have seen publicly the demographics of those individuals. We're hearing that it's among predominantly men 20 to 50 years of age, but we don't know that for certain.

    So the unknown is whether we will see secondary transmission in European and North American countries after that. And that's really important. And it's really critical that we be very careful how we talk about this disease to avoid any type of social stigma. This is an infectious disease that can be managed, can be treated, and can be prevented, whether or not the U.S. government decides to deploy the smallpox vaccine, and which one they will use, because one of them that we have is a non-replicating virus.

    And if you're concerned about its use in individuals who are HIV-positive, that might be the preferable vaccine, although we only have about 1,000 doses of that one stockpiled, as opposed to the tens of millions of the more — the older, more conventional smallpox vaccine.

  • John Yang:

    Dr. Peter Hotez from the Baylor College of Medicine, thank you very much.

  • Dr. Peter Hotez:

    Thank you.

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