In January 2020, when the World Health Organization sounded the alarm about Covid-19, already 12,000 people in China and nearly a hundred in 18 other countries were affected. Two years later, the WHO again declares a global health emergency, this time for monkeypox which has exceeded 17,000 cases – including more than 11,000 in Europe alone – and affects 75 countries. But the two epidemics are difficult to compare, if only in terms of mortality. Monkeypox has only killed five people this year so far. This is the reason why the experts did not agree among themselves on the conduct to adopt in the face of the virus.
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For Yannick Simonin, virologist and teacher-researcher at InsermUniversity of Montpellier, this decision should be welcomed because it did not “did not reach consensus”. But he believes that in view of “the evolution of the current situation, i.e. an increase in the number of constant cases and difficulties in controlling the epidemic“, he sees a “positive sign” who will be able to “trigger appropriate measures” and “accelerate vaccination campaigns”.
franceinfo: 17,000 cases worldwide, including more than 1,500 in France, and almost all the patients are young homosexual men. Why is this profile particularly affected?
Yannick Simonine: We note in fact that the vast majority of cases identified are men who have had sexual relations with other men. It is therefore part of the homosexual community that is affected: we are at about 96% of confirmed cases in men. We have a few elements that allow us to know why this community is particularly affected. Probably, it is originally related to clusters that appeared in certain countries and the level of gatherings that took place within this community. The virus thus spread quite quickly, especially among young adults with an active sex life who helped to promote the spread of this virus within this community. But that doesn’t mean it’s a disease that’s uniquely restricted to the homosexual community and it’s a disease that can potentially spread within the heterosexual community as well. So it’s not a disease in itself that only affects or will only affect the homosexual community if we let it spread and we don’t put in place control measures.
Two weeks ago, on our antenna on franceinfo, you expressed your concern with this WHO alert. To what extent is it necessary to worry today?
It is extremely difficult with this disease to be able to precisely trace the contact cases, the chains of transmission, since we are on a growing number of cases, with more than 17,000 cases in Europe. Therefore, tracing the chains of transmission becomes extremely complicated, especially since people who have been infected with monkeypox have difficulty identifying the precise context in which they were infected, as well as the person who could have infected them. As a result, we are forced to go through a more global, more general vaccination within the homosexual community to curb the spread as quickly as possible. Probably, it is to be expected that the number of cases will continue to increase in the coming weeks and months, because the effect of vaccination takes time. It takes two doses of vaccine for people who have never been vaccinated against human smallpox, so it’s a long time to have the effects of vaccination.
What are the current health risks of this monkey pox?
Most cases are relatively mild. Of the 1,500 cases in France, there are around thirty hospitalizations, which may not seem like a lot. But you should know that it is a disease that can be extremely painful, disabling and has an effect on people who are infected, even when the cases are mostly mild. It is also necessary to observe the potential evolution of this virus: the more a virus circulates within a given population, the more it can potentially accumulate mutations. Nevertheless, monkeypox is not like Covid, it is a more stable virus, which mutates much less, but which evolves and mutates all the same, at the level of the sequences available. The longer a virus is allowed to circulate, the longer a virus is allowed to mutate, the greater the risk that the virus will adapt more to humans. This is why we must act as quickly as possible to curb the circulation of this virus and limit the risks that it will also evolve.
Can we recall the symptoms?
The symptoms that we currently observe are a little different from the symptoms that we observe in the endemic zones of this virus, that is to say in the zones where the virus usually circulates. Skin rashes are observed, mainly on the genital areas, but also on the face, the palms of the hands, the soles of the feet, associated with a fever which can be moderate. Subsequently, these rashes will give kinds of pustules which will gradually turn into scars which can be extremely debilitating, and then which can also be associated with secondary bacterial infections. Therefore, it is above all these risks of development at the level of the skin lesions that can lead to hospitalizations.