A plague on all our houses: monkeypox rears its head

Here we go again, are we facing another pandemic and if so, are we prepared?

The current outbreak and spread of Monkeypox, now referred to as Mpox should focus our attention on the fact that infectious diseases remain entrenched in our world and have the ability to mutate and spread at ease.

Mpox is a viral zoonotic disease first discovered in parts of Central, East and West Africa. The first human case occurred in the Demographic Republic of the Congo in 1970 and in the following years the virus became entrenched in parts of Central, East and West Africa.

The first global outbreak of Mpox occurred in 2022-23 when the disease spread to countries around the world including some in Europe.  By mid-2022, Mpox had spread to almost 100 countries, including some in Europe and Asia.

Mpox is an infective disease transmitted through close contact through sexual behaviour, skin-to-skin contact, or breathing close to an infected person. There would now appear to be two main strains of the disease, Clade 1 and Clade 2. Clade 2 is a relatively mild form of the disease whereas Clade 1 and a new variant Clade1b which seems to be spreading throughout the world, are much more deadly so far causing more than 30,000 cases and more than 1,500 deaths.

So far the natural reservoir of Mpox remains unknown but there is little doubt that the disease circulates in wild animals in parts of Africa sporadically creating minor outbreaks. The irony is that we simply shrug our shoulders at a disease circulating among wild animals in isolated parts of Africa despite the fact that an outbreak of the disease occurred in a number of Mid-Western states the USA in 2003.

In this outbreak 80 people caught the infection but no deaths occurred. This was the first time Mpox had been recorded as occurring outside Africa and was linked to a number of Americans importing live exotic pets such as bears and monkeys from parts of Central Africa.  In the following decades many Americans and Europeans visited isolated and remote parts of Africa and Asia exposing themselves to Mpox as well as a number of other infections.

But how concerned should we be about the present outbreak of Mpox? The recent surge of Mpox throughout Africa and possibly spreading to parts of Europe and Asia has prompted the WHO to issue a worldwide alert.  

So far more than 15,000 cases of Mpox and 537 deaths have occurred.  We seem to forget that we live in a world subject to many old and new infectious diseases and continue to believe, that we are the dominant species and that infectious diseases are only a minor upset.

Nothing could be further from the truth as Covid-19 demonstrated. There is little doubt that we continue to downplay the significance of the biophysical environment, the importance of the ability of bacteria and viruses to spread and mutate, and the significance of the animal world. The recent outbreak of Covid-19 and now Mpox shows that whatever we think and do, infectious diseases continue to appear in our world and that pandemics and epidemics are always just around the corner.

If we are facing another pandemic one can rightfully ask - did we learn anything from our experience of Covid-19? I very much doubt it. Like Covid-19, Mpox demonstrates the weakness of our understanding the significance of the Natural Biophysical World and our inability to understand the relationship that exists between animal and human diseases. Covid-19 also demonstrated the role that our media plays in our lives often playing a defining role in how ordinary people view risk and how they behave when confronted by infectious disease outbreaks.

Vaccination is probably the best way to avoid Mpox spreading. Ironically the smallpox vaccine helped contain Mpox spreading and affecting large numbers of people. But for many people those days have gone and while there may be new vaccines available our experience of Covid-19 shows how difficult it is to ensure most people are vaccinated.

And critically, as Covid-19 also demonstrated, during times of epidemics and pandemics we are faced by an outbreak of fear, hysteria and panic and question whether our Government and Medical Fraternity fully understand how ordinary people regard risk in their lives and can fully protect us during times of crisis.

So, are we prepared to face the possible spread of Mpox in Australia? Should we begin to stockpile anti-viral drugs and keep a good eye on people returning from time spent in Africa and Asia. The USA and some European countries have stockpiles of vaccines but is it enough to stop the disease spreading once it is introduced. We were told much the same during the Covid-19 outbreak, but many people struggled when confronted by the disease.