As if one pandemic weren’t enough, a dangerous new virus is spreading all over the world. Starting around two weeks ago, monkeypox—a pathogen that originated in West and Central Africa and causes flu-like symptoms and a rash—cropped up in places where it’s not usually found.
Portugal, Spain, and the United Kingdom have reported a few dozen cases between them. And now the United States. Authorities in Massachusetts detected the infection Tuesday night, and the U.S. Centers for Disease Control and Prevention quickly confirmed it.
But don’t panic. The world has contained outbreaks of monkeypox before. And we’re even better-prepared for the virus now that we’ve had three years of practice with the novel-coronavirus.
“I’m not worried about anything resembling an outbreak,” Irwin Redlener, the founding director of Columbia University’s National Center for Disaster Preparedness, told The Daily Beast. He was using the epidemiological definition of outbreak, which is a sudden spread of an unusual disease, but in a small geographical area rather than globally.
The handful of monkeypox cases in a handful of countries don’t yet qualify as an outbreak, by many scientists’ standards. Could the virus spread to more people in more countries? Yes. But don’t expect it to be anything like the spread of COVID. “SARS-CoV is much more contagious than other infections,” Stephanie James, the head of a viral testing lab at Regis University in Colorado, told The Daily Beast.
Slower spread means authorities have more time to confirm cases, isolate the infected people and trace their recent contact with others. There isn’t a monkeypox-specific vaccine, but the virus is similar to smallpox, so smallpox vaccines should be reasonably effective—and a useful tool for blocking the pox’s transmission once contact-tracers have identified the people who are at risk.
That’s what happened in 2003, the last time monkeypox got a significant toehold in the United States–that time via pet rodents shipped to Texas from Ghana in West Africa. Forty-seven people fell sick, but a rapid response by state and federal health officials–and a few doses of smallpox vaccine—prevented anyone dying and quickly, albeit temporarily, eliminated the virus in the U.S.
Monkeypox, which first made the leap from monkeys or rodents to people in the Democratic Republic of Congo in Central Africa in 1970, flares up here and there from time to time—usually in Africa. But it rarely infects more than a couple thousand people a year—and killed just 33 people during its most prolonged outbreak in the DRC between 1981 and 1986.
There are good reasons why monkeypox isn’t nearly as contagious as COVID. Where COVID spreads via very fine droplets of spit—the kind that all of us spew for yards in all directions every time we breathe, talk, laugh or cough—monkeypox prefers bigger droplets that don’t travel very far. It can spread via direct contact between the pathogen and an open wound, too, but that transmission pathway is even less likely than those big, fast-falling droplets.
The key to containing monkeypox is identifying it quickly so the isolation, contact-tracing and treatment can begin before the virus spreads too far. We were pretty good at that a generation ago. We’re even better at it now, thanks in no small part to COVID. “Most of the world is much better prepared for monkeypox than we were two and a half years ago,” Paul Anantharajah Tambyah, president of the Asia Pacific Society of Clinical Microbiology and Infection in Singapore, told The Daily Beast.
“We need to figure out what’s going on—quickly.”
Testing is more sophisticated—not just for SARS-CoV-2 infections, but for a whole host of viral diseases. “I would like to think that we have learned how to conduct mass testing more efficiently,” James said. “PCR tests are actually easy as long as we have the correct reagents. We can also test for multiple viruses at the same time.”
We’re better at contact-tracing, too. Investigating people’s movements and relationships in order to map out who they’ve come in close contact with, and when, was a niche practice three years ago. Today many tens of thousands of health workers all over the world have experience with contact-tracing.
The general public is more alert, too. Sure, COVID-related restrictions on schools, business and travel irritate a lot of people. No one loves wearing a mask. Small but stubborn minorities in some countries even refuse to take the free, safe and effective vaccines that offer strong protection against the worst outcomes from a COVID infection.
But that recalcitrance belies the deep awareness most people now have when it comes to viral diseases. People are probably going to notice if a friend, neighbor or family member comes down with the pox—and they’re probably going to take it seriously. “The COVID-19 pandemic has shone a light on the critical importance of staying ahead of infectious disease threats instead of constantly chasing behind them,” Anne Rimoin, a professor of epidemiology at the UCLA Fielding School of Public Health, told The Daily Beast. “The world is now familiar with the terms ‘case investigation,’ ‘contact tracing’ and ‘genomic sequencing.’”
Perhaps most reassuringly, we’ve already got a vaccine. With COVID, we had to lock down and wait for a year before the first jabs were ready. But since the smallpox vaccine works on monkeypox, there’s no waiting.
If there’s a cause for concern in the recent spate of monkeypox cases, it’s that we don’t yet know exactly where and how it started. Pinpointing the origins of a viral spread obviously helps to contain it. “We need to figure out what’s going on—quickly,” James Lawler, an infectious disease expert at the University of Nebraska Medical Center, told The Daily Beast.
“That said, in general, we think of monkeypox as much less lethal than smallpox, easier to control in terms of transmission and amenable to vaccines and antivirals,” Lawler added.
All this is to say, don’t worry. Unless a contact-tracer comes knocking (an unlikely proposition) or you notice weird blisters on your neighbor or yourself (even more unlikely), you don’t need to do anything differently. “The risk to the general public is very low,” Rimoin said.
Monkeypox is making one of its periodic comebacks. But this is one virus we’re really good at containing.