Somehow or other the world seems to be jumping out of the frying pan into the fire then putting more coals on themselves. When health of all people should be as high on our priorities as peace between nations we are letting ourselves down.
Since reports of a mystery disease found in Wuhan in 2019 the world has learned to live with COVID-19, Coronavirus or SARS-CoV-2, that is a worldwide pandemic we are still living with despite every effort to develop vaccines that will eventually eradicate it. Thus far it has mutated faster than scientists can develop vaccines that can eliminate the disease conclusively. Now another virus has begun disquieting people. Understandably, after two years of pandemic, a new viral epidemic will frighten people. It is no surprise that when countries across Europe and North America detected cases of monkeypox, generally found in central and western Africa, there is a bit of a panic. Now over 100 cases have been confirmed in 16 countries.
So now we have monkeypox, a viral zoonosis transmitted to humans from animals with symptoms similar to smallpox, although clinically less severe. Its name comes from the first documented cases in 1958 when two outbreaks occurred in monkeys kept for research; however, it did not jump from them to us. Monkeys are not even major carriers of it.The first human case was recorded in 1970 in the Democratic Republic of Congo during efforts to eliminate smallpox. The virus belongs to the orthopoxvirus genus of the Poxviridae family, to which the variola and smallpox viruses belong; its symptoms a distinctive rash, pustules and fever. Smallpox was a serious infectious disease affecting humans for thousands of years before eradication in the late twentieth century. Global eradication of smallpox over forty years ago was a great achievement in public health. The last naturally occurring case was reported in 1977; thus, in 1980 the World Health Organisation declared it had been eradicated. There is no evidence of naturally occurring smallpox transmission anywhere today. However monkeypox is spreading and it has been said that with the decline of smallpox vaccinations it may be ‘replacing’ it.
Viruses mainly adapt to hosts by evolving efficient interactions with host cells tocommence infection thus producing large amounts of virus. Those vires spread to different organs in the host causing tissue damage. Strains of virus differ in their virulence to cause fatal disease, whereby differences may be due to the rapidity of virus replication and spread, amounts of vires produced and ability to damage cells in which vires replicate or capacity to evade the immune response of their host.
One of the most virulent was poliomyelitis, polio, an infectious disease caused by three types of poliovirus, a serotype of Enterovirus C of the Picornaviridae family. Inroughly 0.5% of cases, it moves from the intestine to central nervous system where it can invade the neural system causing paralysis. That can occur within hours or days. It is still endemic in Afghanistan, Nigeria and Pakistan, but eradicated elsewhere, except for occasional cases. Between January 2020 and April 2022, less than 2,000 cases were reported globally. Pakistan is considered the main exporter of ‘Wild Polio Virus’ (WPV) with the highest number of outbreaks in the endemic countries. It is a highly infectious disease that mostly affects children under age five, transmitted person-to-person mainly through a faecal-oral route, less frequently by contaminated water or food. Polio vaccination is the best protection against the three types of WPV. Cases have decreased by over 99% since 1988, an estimated 350,000 cases in over 125 endemic countries to 175 reported cases in 2019. WPV type 2 was eradicated in 1999 and no case of WPV type 3 has been found since a reported case in Nigeria in 2012. Both have officially been certified globally eradicated. Now WPV type 1 especially affects two countries, neighbouring Pakistan and Afghanistan.
The world has a long history of pandemics from antiquity to modern times. The worst ever arrived in Europe during 1347, with an estimated 25 to 50 million deaths from 1347 to 1352. That was almost 40% of the population, although other estimates say 60%. It was not a viral disease, but an infectious fever caused by the bacterium Yersinia pestis, probably transmitted from rodents to humans by the bites of infected fleas. Almost 700 years after the Black Death pandemic it still preoccupies the world as the worst ever. It was believed to have started in China in 1334, spread along trade routes to Europe via Sicilian ports in the 1340s. The Great Plague of 1665 to 1666 was the last major outbreak of bubonic plague in England after which measures including quarantines and improved hygiene reduced the risk. The Great Fire of London between 2 and 6 September 1666 may have helped end it by killing many of the rats and fleas. Failures in quarantine barriers brought about a serious outbreak in Marseille in 1721 that did not spread extensively across Europe when quarantine measures were reinstated. Although not a viral disease, bubonic plague still occurs occasionally, reminding us there is much more than just being vaccinated to prevent the spread of diseases. Whatever was learned from the plague was forgotten during colonisation of other parts of the world, leading to a series of pandemics that spread such diseases as chickenpox, measles and smallpox, which killed the majority of native peoples of the Americas and infected other parts of the world.
We are still fighting some of those diseases, but somehow they are among us and monkeypox should be a serious reminder that, as scientists warn us, we can expect more pandemics in the near future.
Featured image by Anna Shvets on Pexels.