(CNN Spanish) — Monkeypox and covid-19 share, since the weekend, the same categorization: the WHO considers both “public health emergencies of international concern”. This decision – which comes when more than 16,000 cases have already been registered in 75 countries around the world and at least five deaths – brings a key question back to the table: how are these diseases similar and different?
Since 2005, when the International Health Regulations were created to prevent and respond to public health risks that can spread globally, six such emergencies have been declared. Two are in force, those for covid-19 and polio, and four had already been terminated: the H1N1 influenza, Ebola in two different time periods, and the Zika virus.
When does the World Health Organization (WHO) declare an emergency? This definition is taken “when a disease occurs that is serious, sudden, unusual or unexpected, then they determine that all the countries of the world (…) must work in a coordinated and articulated manner to establish surveillance tasks, detection of cases, the use of medications, vaccines, etc., against the disease in question,” explained Dr. Huerta, a Public Health specialist and contributor to CNN en Español.
The WHO determined that there is a moderate risk worldwide for monkeypox except in Europe, where it was classified as high. But that does not mean that we are facing a situation like the one in March 2020. At least four factors differentiate covid-19 from this virus.
1. Monkeypox, less contagious than covid-19
Monkeypox “is a much less contagious disease than covid-19 or influenza and it is possible that it will not generate an epidemic of the magnitudes that we are used to with covid-19 at this time,” he recently explained to CNN in Spanish epidemiologist Felipe Lobelo.
One of the great differences between these two viruses is in transmission, Public Health experts have said on multiple occasions.
“Monkeypox is spread through direct contact with bodily fluids or sores on the body of someone who has monkeypox, or through direct contact with materials that have come in contact with bodily fluids or sores, such as clothing or bedding. It can also spread through respiratory secretions when people have close face-to-face contact,” the CDC says. There is no evidence that it remains in the air and that it is transmitted that way by sharing short periods.
In its message when declaring the emergencyHowever, WHO director-general Tedros Adhanom said the outbreak has spread rapidly around the world “through new modes of transmission about which we understand very little.”
In this regard, scientists who are studying the outbreak affirm that people do not seem to be infected simply by friction, but that it is the product of more prolonged contacts. But this is under study.
2. Most detectable symptoms
Symptoms of monkeypox usually begin within three weeks of exposure and can resemble the flu, including fever, headache, muscle aches, sore throat, cough, chills, and exhaustion. according to the CDC.
However, it also has distinctive features that are swollen lymph nodes and a rash that can look like pimples or blisters and can appear on various parts of the face and body, including the genital area.
The symptoms of monkeypox, especially these rashes, are also more detectable than the symptoms of covid-19. And to this is added another factor: no cases of asymptomatic spread have been documented, according to a 2020 study, a fact that complicated the response to contain the coronavirus.
3. Monkeypox, an old acquaintance
Another substantial difference between covid-19 and monkeypox is that the latter is an old acquaintance: the first case in humans dates back to 1970 in the Democratic Republic of the Congo and since then cases have been systematically reported (although far from the dimensions of the current outbreak).
Consequently, there are already vaccines available to deal with this virus —in addition to the fact that there are vaccines against smallpox that were eradicated more than 40 years ago, the composition of which is also effective—.
In the United States, for example, the Jynneos monkeypox vaccine is specifically licensed, as is the smallpox vaccine ACAM2000.
The CDC states that it is recommended for those who have been exposed or are at high risk of exposure to the virus. And they affirm that, in the first case, it can bring benefits if it is placed in a period of four to 14 days after that exposure.
That there are vaccines does not mean that there is wide availability worldwide, which in fact there is not according to the WHO. However, it is a significantly better starting point than covid-19, which led to a million-dollar race against time to develop a vaccine that could prevent infection.
4. Different mutation rates
All viruses mutate, a reality that we are especially aware of at the moment, in which the BA.5 subvariant of ómicron is pointed out as being responsible for the sharp increase in cases of covid-19.
However, Dr. Richard Kennedy, professor of Medicine and co-director of the Mayo Clinic Vaccine Research Group, recently told CNN en Español. the monkeypox virus, like all of the monkeypox family orthohopox“it is a DNA virus and mutates more slowly than RNA viruses such as SARS-CoV-2”.
The more people are infected, the more likely it is that the virus will mutate, since viruses can only mutate when they are in an infected cell.
“Most mutations are harmful to the virus or have no effect on it (…). Every now and then a mutation occurs that is beneficial to the virus. When this occurs, the mutated virus still needs to be passed on.” to more people to spread. This is easy for highly infectious viruses. It will be more difficult for monkeypox virus.”
With reporting from CNN’s Carma Hassan, Carolyn Sung, Neeraj G. Patel, Brenda Goodman, Deidre McPhillips, Rob Picheta, Hafsa Khalil, Jen Christensen, and John Bonifield.