OBWOGO: 6 Reasons Monkeypox Disease is Not Like Covid-19

The news of a new virus spreading across the globe following close on the heels of a devastating pandemic is a cause for concern. However, the viral illness caused by monkeypox virus is not like the novel coronavirus that causes Covid-19, and, it’s unlikely to cause a major outbreak for six reasons: less contagiousness, requirement for intimate contact to transmit, lack of asymptomatic spread, low fatality rate, well-known preventive measures and availability of effective vaccine.

First, monkeypox is an old, primarily zoonotic disease— transmitted from animals to humans when people come into close contact with infected animals through an animal bite, scratch, bodily fluids, faeces or by consuming meat that isn’t cooked enough— and human-to-human transmission is very rare unless there’s close physical contact (skin-to-skin).

The primary reservoir (main disease carrier) of monkeypox virus is still unknown although African rodents are suspected to play a role in transmission.

?Small (aerosols) and large respiratory droplets

Second, although it can also spread through fomites (contaminated clothing and bedding), and respiratory droplets produced by coughing and sneezing like the novel coronavirus, monkeypox is not an airborne disease. It's made up of double-stranded DNA— makes the virus larger and heavier with a propensity to not travel far from soure— compared to the novel coronavirus which is a tiny, single-stranded RNA virus, making it easy to float in the air and spread faster.

Conversely, airborne transmission through tiny aerosols for the novel coronavirus is a far greater risk than from large respiratory droplets (contaminated surfaces), meaning that in a crowded, poorly-ventilated indoor space, a single infected person can release enough aerosolised viral particles over time to infect many people and seeding a super spreader event.

?Fomites and prolonged face-to-face contact

Monkeypox virus is spread through respiratory droplets— requires prolonged face-to-face contact because the droplets cannot travel more than a few feet— and, in order to infect 30 people through the droplets in one sitting, a single infected person has to be within a few feet of all the 30 people when coughing or sneezing, or to have contaminated an object that all the 30 touched.

Other routes of monkeypox transmission include from mother to fetus via placenta, or during close contact after birth. However, contrary to social media reports, it’s not a sexually transmitted disease and contact with infected lesions containing the virus during sex— as opposed to semen and vaginal fluids exchanged during sex— may explain why the majority of cases identified have been in men who have sex with other men.

?Symptomatic versus asymptomatic spread

Third, unlike the novel coronavirus which can be spread by an asymptomatic person, monkeypox virus is contagious only when an infected person shows symptoms such as lesions and blisters which can be spotted easily and victims isolated.

On average, symptoms appear within six and 13 days after infection and persons experience fever, headache, backache and muscle aches, swollen lymph nodes and general exhaustion. It then enters the body of an exposed person through broken skin, the respiratory tract, or the the mucous membranes (eyes, nose and mouth). Monkeypox virus also creates a rash which can start on the patient’s face, hands, feet, or inside the mouth or genitals, before progressing to the rest of the body.

Fatality rate and contagiousness

Fourth, the case fatality rate for monkeypox is slightly higher than for Covid-19, but the odds of getting infected is higher with the latter than the former ((risk of death is a function of probability of event occurring— contagiousness— and its impact (fatality rate)). For example, although the rare brain-eating amoebas can cause 100 percent fatality rate, the risk of getting infected is extremely rare and only 310 cases have been documented globally so far.?

Moreover, viruses need to mutate to become more infectious, but, compared to RNA viruses, DNA viruses like monkeypox are generally very stable and evolve much slower.

Fifth, the vaccine for smallpox, called vaccinia virus WR, provides lifetime immunity and neutralising immune responses against all human infectious poxviruses, including Variola major and Variola minor, the strains that cause smallpox and monkeypox respectively. As a result, even older adults who were vaccinated against smallpox decades ago still maintain a high level of antibodies and are likely to get milder symptoms if they get infected with the monkeypox virus.

?Preventive measures

Last, the good news is that the same measures used to protect against getting infected with the novel coronavirus— social distancing, wearing masks in public, hand washing and surface disinfection— will also reduce your risk of getting monkeypox.?

Dr Subiri Obwogo is a medical doctor, specialist in public health medicine and independent consultant in health policy and systems strengthening. He’s also the author of two books and several publications. [email protected]