“We’re coming to the end, but we’re not there yet.” The monkeypox epidemic is in full decline, virologist Jean-Claude Manguara told AFP on Friday, October 21. With more than 70,000 cases in around 100 countries since May, “an epidemic of ‘monkeypox’ so important in such a short time is unheard of”recalled this head of the environment and infectious risks unit at the Institut Pasteur.
If since mid-July, the contamination curve has dropped very significantly in Western Europe and North America, certain countries in Central and Latin America are still experiencing an increase. Moreover, at present, monkeypox is “endemic” in ten African countries. In these areas, the epidemic, which is more lethal, stems mainly from contact with wildlife in rural areas.
“The African source remains present and, in a context where there may be population movements, we may have new exported cases and a new epidemic wave at any time”, warns Steve Ahuka Mundeke, head of the virology department at the Biomedical Research Institute of the Democratic Republic of Congo and member of an IRD-Inserm team. These last months, “we have seen again that global strategies are only deployed when the countries of the North are affected, which does not at all clear the African health authorities“, he remarks.
Where the epidemic is declining, experts point to the decisive role of behavior change within communities at risk, in particular thanks to the role “associations, perhaps more listened to than the authorities and closer to the field”, suggests Jean-Claude Manuguerra. Surveys show that more than half of men who have sex with men have reduced their number of sexual encounters.
As for vaccination, “it has helped, but the number of available vaccines remains low”, reminds AFP Carlos Maluquer de Motes, professor of virology at the British University of Surrey. The vaccine is still recommended for prevention and post-exposure. Its clinical efficacy is not yet supported by “hard data”according to the European Center for Disease Prevention and Control, but it shows positive preliminary results.
In any case, “significant uncertainties remain about the evolution of the epidemic”, emphasizes the European agency, which draws four scenarios. Battery: rebound of the epidemic, linked in particular to the return of risky behavior, or reduced circulation of the virus with sporadic outbreaks. Face: persistent decline in the epidemic, even elimination of the disease in Europe.