By the time last week that World Health Organisation director general Tedros Adhanom Ghebreyesus declared monkeypox a “public health emergency of international concern” – the highest level in its hierarchy of warnings – some 16,000 cases had been diagnosed in 75 countries. Europe accounts for three-quarters of confirmed cases in 2022, while in Ireland there have been 85 cases detected, and 10 hospitalisations. Minister for Health Stephen Donnelly insists the Government is taking the virus “very seriously”, but that it is not like others dealt with recently, and the “vast majority” of Irish cases have been very mild. It has a current fatality rate of between 3 and 6 per cent, with recent deaths outside Africa reported in India, Spain and Brazil.
Comparisons with Covid are inevitable but alarmist. The virus is far less easily transmissible, depending largely on intimate physical contact, including kissing and sexual intercourse, and the smallpox vaccine, a similar virus, is effective against monkeypox and already being rolled out to particularly vulnerable communities.
A New England Journal of Medicine study has found that, between April and June 2022, 98 per cent of the infected were gay or bisexual men, and 95 per cent of cases occurred through sexual transmission, figures that tally with Irish findings. All of the Irish cases have been detected in men, with a median age of 37 years, and by a large majority gay. Like Covid, those infected are urged to undergo self-isolation for as much as three weeks.
Repeated assurances of a “low risk of community spread” and the danger that monkeypox may, like HIV, be regarded falsely as a “gay” disease may, however, spread complacency and contribute to dangerous stigmatisation of the vulnerable. There is no guarantee that the virus will not spread far more widely. Its initial history is no necessary indicator of its future course.
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Crucial will be early and co-ordinated action at an international level, says EU health commissioner Stella Kyriakides, if monkeypox is not to turn into a pandemic.