Monkeypox only gets attention after its spread in the rich capitalist countries – the people’s world

Electron microscopic image of oval-shaped mature monkeypox virions. | WHO via AP

If you’ve been following infectious disease news since the COVID-19 pandemic, you may have already seen reports of the increasing number of monkeypox cases. Monkeypox is a disease caused by the monkeypox virus, which belongs to a small family of viruses that also includes smallpox. In fact, monkeypox is so similar to smallpox that it was only recognized as a distinct pathogen after smallpox was eradicated in the 1970s. Smallpox vaccines are often very effective in preventing monkeypox.

Other family members include cowpox, cowpox, and camelpox – each named after the animal they thought they first infected. Viruses are transmitted between infected animals, where the rodents act as a reservoir of infection that can return the virus to other animal populations. Many of these animal foxes are also “zoonoses” (pronounced Zoo-no-see), which means that human infection with these viruses is possible through contact with an infected animal.

The exception in this viral family was smallpox due to its ability to infect only humans, often with debilitating or fatal consequences. Smallpox was eradicated by a major global effort using the “circular” pollination technique.

This involves a major effort to find all the cases of smallpox that appear and to vaccinate anyone the infected person has recently come into contact with – their “ring” of contacts. If vaccination occurs quickly enough after infection it can stimulate immunity before clinical disease occurs. Therefore, circular vaccination stops transmission chains if contact tracing tools successfully inoculate sufficient quickly enough contacts of known cases.

The successful eradication of smallpox in 1980 brought an end to smallpox vaccination and with it the slow decline of episodic immunity to monkeypox. However, monkeypox continued to spread among rodents and monkeys.

Human cases of monkeypox continued at a low level, mostly around the Congo Basin. This region includes Cameroon, Central African Republic, Democratic Republic of the Congo, Republic of the Congo, Equatorial Guinea, and Gabon. The disease apparently showed low human-to-human transmission, not spreading beyond each animal-to-human jump.

However, the true measure of the previous transmission is opaque, and apparent confidence in this may be misplaced. The poor health infrastructure meant that cases could have gone untreated or been confused with other rash diseases such as chickenpox (which belongs to a family of viruses completely different from monkeypox).

Most of the academic literature on monkeypox derives from its occurrence outside the Congo Basin, first in other countries in Central and West Africa and then on to the United States and Europe. Many infectious diseases such as monkeypox become noteworthy to the medical establishment only when they occur outside the countries in which they are expected, where they are called “endemic”.

Today, this approach tacitly assumes that it is possible for someone to die of a disease that is so prominently preventable in the Democratic Republic of the Congo in a way that is unsustainable in the advanced capitalist countries of North America or Europe.

As a result, our understanding of monkeypox is somewhat fragmented and inaccurate outside of the glimpses that its importation into richer countries with richer healthcare systems provides.

A good example of this lack of clarity is that previous records show higher numbers of the more deadly and transmissible genetic cases of monkeypox in the Congo Basin than in the less lethal branch of West Africa. Until 2019, monkeypox cases did not require mandatory notification from the World Health Organization through the Integrated Disease Surveillance and Response System, with the exception of the Democratic Republic of the Congo, which has implemented its own mandatory reporting system. As a result, it is likely that many cases in the West African branch were not counted.

This relatively less-lethal group in West Africa is responsible, as of 4 June 2022, for 780 confirmed cases in 27 countries outside the Congo Basin. The challenge public health authorities in these countries now face is to respond to an outbreak of a virus in which there are still significant gaps in our knowledge, a challenge that has been present in many countries in the Congo Basin for decades.

Unconfirmed estimates of monkeypox transmission prior to the outbreak make it difficult to know whether the strain responsible for the outbreak shows any signs of increased transmissibility.

Despite these doubts, everything we know so far indicates that monkeypox is much more containable than COVID-19. In countries where other diseases causing the rash are rare or nonexistent, the characteristic sores caused by monkeypox virus in all cases will make cases easier to detect. It is also very helpful to have the existing smallpox vaccines, which are effective against monkeypox and can be reused in the ring vaccination strategy.

Genetic analysis of viruses isolated from monkeypox cases in the United States found that two different strains of viruses circulate. One strain is similar to cases of monkeypox currently being discovered in Europe, while the other is very similar to the strain discovered in an American man returning from travel to Nigeria to the United States in 2021. This hints that monkeypox transmission may have been a limitation. Implementation in countries where its presence is less visible for some time.

The likely outcome of an outbreak of monkeypox would be a common pattern in infectious diseases: some wealthy countries would be able to contain their outbreaks and guarantee themselves priority access to smallpox vaccine stocks. Meanwhile, poor countries will struggle to detect imported cases, spread a circular vaccination program, or buy vaccines.

An evolution in public health that has been accelerated and undermined by COVID-19 is the management of emerging infectious diseases by tightening international borders. Protecting sovereign citizens by reactively increasing control of visitors from countries discovering worrisome strains has failed multiple times as a strategy to prevent the importation of new types of COVID-19 into the US, Britain and other countries. Only complete isolation, as in the case of Australia and New Zealand, was able to prevent import completely, but it proved to be an unsustainable tactic in the long run.

Often the temptation here has been to advocate for better disease surveillance in poor countries on the grounds that it will prevent us from importing more animal surprises. This is dangerous. Health care of the world’s poorest and most exploited people should not be justified in terms of improving the health of people in rich countries. No one in the Congo Basin should die of monkeypox – because someone’s health in the Congo Basin should be as important to us as the health of someone in a rich capitalist country.

The scientific consensus remains that the destruction of animal habitats to meet the ever-increasing needs of resource extraction for capital will tilt toward more animal spillovers such as COVID-19 and monkeypox. Emerging infectious diseases with climate disintegration will go hand in hand with the exodus of populations of humans and non-human animals alike.

Eco-Marxist Andreas Malm puts it in his analysis of COVID-19 and the posed climate emergency very succinctly: “The animal spread of such a devastating land scale should make it clear that the defense of wild nature against parasitic capital is now human self-defense. But the conscious regulation of such a defense It’s up to humans only.”

morning star


contributor

morning star


.

Leave a Reply

Your email address will not be published.