Monkeypox is a new global threat. African scientists know what the world is up against

Some researchers in Africa are having their own sense of dread as monkeypox spreads here-we-go-again. The neglected tropical disease of the poor only gets attention when it starts to affect people in wealthy countries.

The fire is spreading. The United Kingdom saw an outbreak of monkeypox on 7 May. More than 700 suspected and confirmed cases had been reported by the end of May. It is the largest outbreak of its kind outside of Africa and it is concentrated among men who have sex with men. Public health officials and scientists are trying to understand how the virus spreads and how to stop it, and they are paying more attention to Africa.

What is happening in Africa will affect what is happening in the West.

The Central African Republic is one of 10 countries in West and Central Africa where monkeypox is endemic. The Democratic Republic of the Congo has the highest number of cases in a single year. The numbers are probably underestimates. In the CAR, infections are more likely to happen in remote rural areas, while in the DR they are more likely to happen in urban areas.

The name of the virus was given after it was isolated from a wild monkey in Africa. It is more common in squirrel, rat, and shrew species, but not in the human population. It helps to isolated people so that the outbreak ends quickly.

Over the past 3 decades, cases have increased in sub-Saharan Africa. The world stopped using the vaccine against monkeypox in the 1970s, shortly before the eradication of smallpox. There is a huge number of people who are now susceptible to monkeypox, says Placide Mbala, who heads the genetics lab at the National Institute of Biomedical Research.

People are moving to the forest to find food and to build houses, and this increases the contact between the wildlife and the population. When villagers move into the forest during the rainy season, they get in contact with the animal reservoir, according to a researcher.

The West African strain of the disease kills about 1% of those it affects. Despite the relatively high disease burden in the DR, the strain of strain found there is 10 times more lethal and has never left Africa. It has never caused a serious outbreak in a city.

It is not clear where the current outbreak started and how long ago. The first patient with an identified case traveled from Nigeria to the United Kingdom on May 4, but did not transmit the disease to anyone else. Two patients who were diagnosed later, one in the United States and the other in the United Arab Emirates, traveled to Africa and may have imported the virus separately. None of the cases identified in recent weeks have any connection to travelers or animals from endemic countries. Many early cases were linked to gay festivals and saunas in Spain, Belgium, and Canada.

Nigeria, Africa's most populous country, has good infrastructure connecting rural areas to large cities and two airports that are among the busiest in Africa, which may have been the source of the virus. Christian Happi is the director of Nigeria's African Centre ofExcellence for Genomics of Infectious Diseases. People in other countries should not point fingers, but work together.

The head of the Nigeria Centre for Disease Control, Ifedayo Adetifa, says that the country gets too much attention because it does more research than its neighbors.

The ability to deal with monkeypox was improving before the current outbreak. The country of the Democratic Republic of the Congo has stepped up its monitoring of the disease, which is important to isolating people and keeping track of the virus. Researchers hope to develop rapid tests for use in clinics nationwide after they were able to diagnose samples using the polymerase chain reaction. Adetifa says that Nigeria plans to make public the genomes of several recent monkeypox isolates. Researchers could use those and other sequence from Africa to figure out the source of the international outbreak.

Africa doesn't have medicines to prevent and treat monkeypox. In the United Kingdom and the United States, high-risk contacts of cases are being offered a vaccine that was approved by the U.S. Food and Drug Administration in 2019. The U.S. Centers for Disease Control and Prevention is testing the vaccine in health care workers, and the approval was based on animal studies.

In the CAR, 14 people with monkeypox have received an experimental drug, tecovirimat, as part of a trial launched by the University of Oxford in July 2021. Up to 500 treatment courses will be provided by the manufacturer of the drug.

The international outbreak has highlighted global health inequalities, but it has also brought attention to the smoldering disease in Africa. The stakes are really high now.