'Possibility of monkeypox becoming a pandemic is low'

CHENNAI: With monkeypox outbreak in several countries, researchers have said that the possibility of the disease becoming a pandemic is wane, and that the virus can be contained by strong surveillance, isolation of confirmed cases, contact tracing, and ‘off-label use’ of smallpox vaccines for ‘ring vaccination’.

However, the group of public health and infectious diseases researchers said that the emergence of monkeypox disease in non-endemic areas is a reminder that infectious diseases and pathogens are not restricted by the geographical borders.

They argued that even though no case has been reported from India so far, there is a need for better preparedness, in a review paper published in a high-impact journal ‘Indian Pediatrics’. Strict surveillance at port of entry and early identification, isolation, and case management are the recommended key to response.

The review paper by epidemiologist and infectious diseases physician Dr Chandrakant Lahariya, and his team, examined the evidence of possibility of emergence of monkeypox cases in newer settings, and also reviewed the available therapeutics and vaccines, particularly the possibility of the disease to evolve into a pandemic.

Pointing out that the majority of monkeypox cases are being detected in men who have sex with men (MSM), the authors said the trend might be linked to an early care seeking by the people belonging to this group.

They also mentioned the need to study the route of transmission of disease through sex, arguing that sexual contact is just a context which provides close physical contact, and thus an opportunity to spread.

According to the study, monkeypox disease is unlikely to become a pandemic due to several factors, most importantly because it is not a new virus and has been present globally for five decades.

There is said to be a reasonable understanding of the structure, transmission, and pathogenicity of the monkeypox virus. In addition, the virus in most cases causes only mild illness, as evident from occurrence of zero deaths since the onset of the ongoing outbreak.

The researchers also said that the virus is less contagious and requires close personal contact to transmit, in contrast to SARS-CoV-2, which had a respiratory spread and a high proportion of asymptomatic cases.

Another reason they gave was the availability of a few smallpox vaccines, which, they said, can be recommended for ‘off-label’ use and be produced in bulk across the globe. However, report underlined that the mass vaccination of the general population is not currently recommended.

The authors recommended that patients with high-risk for complications, including children and pregnant women, should be admitted to the hospital for closer monitoring and clinical care.

The authors suggested that the outbreak in non-endemic countries should be used as an opportunity by India, and other countries, to strengthen their public health surveillance and health system capacity for outbreak and epidemic preparedness.