Scientists have zero in on the beginnings of the Monkey Pox outbreak.

European health officials were shocked when the first cases of monkey pox were identified in early May. The virus was not known to spread easily, let alone infecting dozens and soon hundreds of young people.

The onset of the epidemic is now becoming clear. Genetic analysis shows that although the monkey pox virus is spreading rapidly in the open, it has been quietly circulating in people for years.

Health officials have already identified two versions of Monkey Pox in American patients, suggesting the transfer of at least two separate chains. Researchers in several countries have found cases where there is no known source of infection, indicating an undiagnosed spread of the community. And a research team argued last month that Monkey Pox had already crossed the line from a sustainable person to another.

Genetic information available so far Indicated Trevor Bedford, an evolutionary biologist at the Fred Hutchinson Cancer Research Center in Seattle, said the virus has improved at some point in the past few years.

“Genomic patterns indicate that this happened around 2018,” said Dr. Bedford.

If the virus is adapted to host people, the monkey pox epidemic could spread more frequently and be more difficult to control. There is a danger that the monkey pox could spread from infected people to animals – possibly rats – in countries outside Africa, which has been battling the problem for decades. The virus can persist in infected animals, triggering new infections in humans from time to time.

“We can also transmit it to animals that can spread the disease in and out of wildlife to humans,” said Sagan Front, an anthropologist at Pennsylvania State University. And what is the study of animal interactions?

Dr. Front said that the longer it takes to control the virus, the more likely it is that people or animals will find a permanent new home.

As of Wednesday, the United States had identified 156 cases in 23 states and the District of Columbia. The global number has exceeded 3,400 confirmed cases, and another 3,500 cases are being reviewed, three times more than two weeks ago.

In Africa, eight countries reported more than 1,500 suspected cases and 72 deaths as of June 10, most of them in the Democratic Republic of Congo.

Monkeypox is a large double-stranded DNA virus, about seven times larger than the corona virus. DNA-based viruses can correct their mistakes when they copy their genetic material. They can collect only one or two mutations per year, while 20 to 30 mutations are for RNA viruses, such as corona viruses.

But the Monkey Pox virus seems to have accumulated an unexpectedly large number of mutations – according to preliminary analysis, about 50 more than the circulating version in 2018.

Of the 47 mutations identified in one analysis, 42 have separate signatures of an enzyme called apobec3. This enzyme, which was first discovered by researchers studying HIV, is a so-called host defense factor – an immune system weapon used by animals and people to disarm viruses such as monkey pox.

The enzyme basically forces the virus to make mistakes when they try to replicate, causing them to destroy themselves. Mice have only one version of this enzyme, while humans have seven. Dr Bedford said the rapid accumulation of enzyme-specific changes since 2018 suggests that Monkey Pax has become a host to people around it.

It is not clear how mutations can change the virus. Of the 48 mutations identified in the UK, 21 could affect how the disease spreads, its severity and how well it responds to a treatment called tecovirimat, according to the UK Health Security Agency.

But since mutations introduced by the enzyme Apobac3 are intended to harm the virus, their amount is not the only concern, said Michael Malim, a virologist at King’s College London. “Comparing the current version of the virus with samples from the last few years may help to understand how it evolved, but the information is scarce,” he said. There was no capacity.

Since then, scientists in Nigeria have been analyzing a series of about 50 cases of monkey pox, according to Dr. Ifedayo Adetifa, director of the Nigeria Center for Disease Control. “But without the special tools or expertise needed for rapid analysis, scientists have not yet completed their work,” he said.

Although researchers have made numerous requests for data from outside Nigeria, Dr. Adifa said he would wait for his work to be published to prevent more resourceful teams from competing and taking credit.

“I’m for open data sharing and all that,” he said. “The question is who benefits?”

Some experts have warned for years that the eradication of smallpox in the 1980s posed a threat to the wider family of pox viruses and increased the chances of monkey pox becoming a successful human pathogen.

In West Africa, the incidence of monkey pox has increased at least 20 times since 1986. In African countries in general, Dr. Adifa said, “We suspect somewhat less reporting because there is relatively less awareness and potentially less risk of monkey pox.” He added that Nigeria is stepping up its surveillance of monkey pox, and the number of cases could increase as more people become aware of the virus.

Although monkey pox has a specific rash that appears on the palms of the hands and soles of the feet, it is often confused with chicken pox. The current epidemic has sores on many men’s genitals, but they can be mistaken for sexually transmitted infections such as syphilis, gonorrhea and chlamydia.

Researchers in Italy and Germany have reported the discovery of Monkey Pox DNA in semen, but it is unclear whether the virus is spread in this way or only in semen and vaginal secretions.

Outbreaks appear to be exacerbated during adolescent genital warts. In 2017, 228 suspected cases of Monkey Pox were recorded in Nigeria and 60 were confirmed. The virus mainly spreads to young people who have genital ulcers.

Experience in the UK shows how difficult it can be to detect the transmission of a sexually transmitted virus, especially in cases where infected people have multiple anonymous partners. In a preliminary analysis of a subset of cases, authorities said they managed to get the names of less than a third of the 78 reported sexual encounters.

Many cases have been reported in Africa regarding contact with wild animals or the use of animal products for medicinal or cultural purposes.

As deforestation and urbanization bring people and animals closer together, more viruses can reach human hosts. Monkey pox rats are the most likely to jump into humans. There are about 2,000 species of rats worldwide, accounting for 40% of all mammals. The African rope squirrel is a leading candidate as the main reservoir of monkey pox, but there are other contenders, including striped mice and dormes, giant pouched mice, rusty-nosed mice and brush-tailed porcupines.

In a 2003 outbreak in the United States, a consignment of Gambian pouched rats imported from Africa transferred monkey pox to prairie dogs, which then infected 71 Americans. But authorities found no signs of the virus in animals in the United States once the case was settled.

There is no guarantee that luck will be with you this time. “This spread from other species, and what it means and what the pace is – it’s very unexpected,” said Dr. Malim. “And it’s happening more and more.”

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