“It’s too early to call it an epidemic”

Although it is still too early to talk about the monkey epidemic, despite the recent increase in reported cases, the emergence of this phenomenon should act as a concern, said Antoine Flao, director of the Institute of Global Health at the University of Geneva.

Question: There are growing cases in North America and Europe: can it be called an epidemic?

A: We are witnessing an unusual phenomenon, but it is still difficult to know whether it will explode into an epidemic or whether its spread will be more restrained. In recent days, the number of cases has doubled every three to four days, which may indicate an exponential rise in the epidemic wave.

However, it is also possible to question whether the recent media coverage of this phenomenon has prompted patients to consult their physician and their physicians to discuss the diagnosis more and report cases. So it is still a little early to talk about the epidemic, but the beginning of the epidemic will really be reminiscent of what we are witnessing now.

Q: Is the spread of the disease surprising and alarming?

A: The emergence of this phenomenon, which is new outside of equatorial Africa, should alert us and make us very cautious. It would be much more effective in terms of health and much less social and economic impact to isolate the few cases identified today for three weeks and require quarantine for highly suspicious contacts.

Indeed, we can now try to dismantle all transmission chains because we have only a few cases and not wait until we are overwhelmed by a possible influx of cases about which we know little, have few treatments or vaccines available.

It should always be remembered that the epidemic development of infection follows an exponential law, which can be very rapid. At the moment, what we know about the monkeypox virus does not make us afraid of mass infection of the general population. If the virus has not evolved much, both in terms of its transmissibility and modes of transmission, this virus is not known to be very transferable.

We know, after 50 years of experience in Africa, that this virus requires strong interpersonal debauchery with someone contagious for infection to occur.

Q: Is there a risk, as in the case of COVID, that it will become global pandemic?

A: We cannot rule out any scenario at this stage. And the pandemic scenario cannot be completely ruled out.

However, there are other less pessimistic scenarios that are at least as plausible as the scenarios. No chain infections of more than six people have been reported so far. The level of reproduction in Africa has always been below 1, i.e. without pandemic potential.

Perhaps the conditions for human-to-human transmission have been created through increased adaptation virusbut also to mobility and to networks of human communities living in close proximity.

The HIV / AIDS pandemic also began with the infection of some segments of society, in particular male homosexual communities and people who exchanged needles.

We then saw how the pandemic spread to other populations, blood transfusion patients, sex workers, and then heterosexual couples and newborns of infected mothers.

At this point, however, there is no evidence of that monkeypox virus sexually transmitted. It seems to be more transmitted through close and prolonged contact with an infected person who has blisters on the skin.

In this case, there is no reason to limit oneself to the male homosexual community. Other populations, particularly children and heterosexual couples, may then be affected.

© 2022 AFP