Monkeypox spread pattern similar to early cases of HIV/AIDS, say scientists

The pattern monkeypox disease is showing in terms of transmission is similar to AIDS in its initial spread in the world, scientists have cautioned.

Experts from the United States’ medical research agency National Institutes of Health (NIH) have said in an editorial published the New England Journal of Medicine that most monkeypox cases are among men who have sex with men, the epidemiologic pattern of the multi-continent outbreak of monkeypox resembles that of the early cases of AIDS.

 
Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), and H. Clifford Lane, M.D., NIAID deputy director for clinical research and special projects have discussed a published case series detailing the symptoms and outcomes of 528 people with monkeypox from 16 countries in five continents.

“However, that it should not be assumed that cases of monkeypox will remain confined to this population. monkeypox virus has been known to spread from direct lesion-to-skin contact—in prior outbreaks, such spread was often from an infected child to a caregiver. Data suggest that sexual transmission likely plays a role in the current outbreak,” said the scientists.

According to the study, the suspected means of monkeypox virus transmission as reported by the clinician was sexual close contact in 95 per cent of the persons. Although it was not possible to confirm sexual transmission, however, a sexual history was recorded in 406 of 528 persons.

Among these 406 persons, the median number of sex partners in the previous 3 months was 5 partners. Around 28 per cent reported travel abroad in the month before diagnosis, and 20 per cent had attended large gatherings more than 30 persons, such as Pride events i.e. events celebrating lesbian, gay, bisexual, transgender, and queer social rights.

Overall, 32 per cent were known to have visited sex-on-site venues within the previous month, and 20 per cent reported engaging in “chemsex” which means sex associated with drugs such as mephedrone and crystal methamphetamine in the same period, the study data showed.

“The health setting of initial presentation reflected referral patterns and included sexual health or HIV clinics, emergency departments, and dermatology clinics and, less commonly, primary care,” authors said.

Monkeypoxvirus (MPXV) is a double-stranded DNA virus, a member of the orthopoxvirus genus within the Poxviridae family. Poxviruses cause disease in humans and many other animals. Infection typically results in the formation of lesions, skin nodules or disseminated rash. Other orthopoxvirus (OPXV) species pathogenic to humans include cowpox virus, and variola virus that causes smallpox, which has been eradicated. 

The International Health Regulations Emergency Committee on the multi-country outbreak of monkeypox had held its second meeting on 21 July 2022. Having considered the views of Committee Members and Advisors as well as other factors in line with the International Health Regulations (2005), the World Health Organization (WHO) Director-General on 23 July 2022 declared this outbreak a public health emergency of international concern.

India has so far 9 cases of monkeypox and it is pertinent to note that India has an estimated 24.01 lakh number of People living with HIV (PLHIV), according to the union health ministry’s HIV Estimation 2021 report.

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