There have been 72 reported deaths around the world due to monkeypox this year. Image Credit: Shutterstock

Dubai: More than 30 countries where monkeypox is not endemic have reported outbreaks of the viral disease as confirmed cases approached 1,900 on Thursday, most of them in Europe.

Until the past few months, monkeypox had generally been confined to Western and Central Africa.

This has led to a group of researchers seeking a "non-discriminatory and non-stigmatising nomenclature" for the infection.

WHO Director General Tedros Adhanom Ghebreyesus confirmed at a briefing Tuesday that the agency would announce "the new names as soon as possible."

So why exactly are scientists calling for a change of name?

What is monkeypox?

Monkeypox is a rare disease caused by infection with monkeypox virus, which originates in wild animals like rodents and primates, and then spreads to people.

It’s usually a mild viral infection. The virus belongs to the same family as the smallpox (Orthopoxvirus genus in the family Poxviridae). This genus also includes variola virus (which causes smallpox), vaccinia virus (used in the smallpox vaccine), and cowpox virus.

How many strains of the virus are known?

The WHO has said there are two main strains:

• Congo strain

• West African strain

Monkeypox india
Health workers screen passengers arriving from abroad for Monkeypox symptoms at Anna International Airport terminal in Chennai on June 03, 2022. Image Credit: AFP

How many cases have been reported in the latest outbreak and where?

This year, more than 1,600 monkeypox cases have been confirmed, and nearly 1,500 more are suspected, according to data that 39 countries sent to the WHO.

Most of those countries - 32 - had not previously reported infections, raising concern among the global health community that the virus is not behaving as it normally has in the past.

There have been 72 reported deaths due to the illness this year, all in countries that previously have had bouts of monkeypox transmission.

WHO has said that Europe remained the epicentre of the global monkeypox outbreak with 25 countries reporting more than 1,500 cases, or 85 per cent of the global total. This is in contrast to the past when monkeypox had generally been confined to Western and Central Africa.

monkeypox vaccine
A healthcare worker administers a monkeypox vaccination at a clinic run by CIUSSS public health authorities in Montreal, Quebec, Canada, June 6, 2022. Image Credit: Reuters

Why do researchers want to rename monkeypox?

The recent international outbreak of the viral illness, which has been historically endemic to central and West Africa, has had no connection to those regions. Twenty-nine biologists and other scientists who wrote a June 10 post on the online forum Virological said that calling it monkeypox unfairly associates the transmission with the continent.

"In the context of the current global outbreak, continued reference to, and nomenclature of this virus being African is not only inaccurate but is also discriminatory and stigmatising," the researchers wrote.

They also pointed out to the media's use of photos of African patients from previous epidemics to depict the pox lesions commonly associated with the disease.

What does WHO say?

WHO Director General Tedros Adhanom Ghebreyesus said the agency would announce the new names as soon as possible. The WHO will hold an emergency meeting next week to assess whether the current spread of monkeypox constitutes a public health emergency of international concern, or PHEIC.

Have the researchers suggested any names?
The scientists suggest the name hMPXV, which begins with an "h" to denote the human version of the virus.

The scientists also proposed classifying the lineage of monkeypox by letters and numbers based on when outbreaks are discovered rather than location, which stigmatises some countries or regions for finding and reporting a virus that could have originated elsewhere.

What policy did WHO use for naming COVID-19?

The WHO website says that from a risk communications perspective, using the name SARS (Severe Acute Respiratory Syndrome) can have unintended consequences in terms of creating unnecessary fear for some populations, especially in Asia which was worst affected by the SARS outbreak in 2003.

For that reason and others, WHO began referring to the virus as “the virus responsible for COVID-19” or “the COVID-19 virus” when communicating with the public.

Later, WHO named various variants of the coronavirus using Greek alphabets (Alpha, Beta, Gamma, Delta, Kappa and Omicron) to simplify public discussions and also help remove stigma from the names, which identified them from the countries they were discovered.

How fatal is monkeypox?

In Africa, —the Congo strain is more severe "with up to 10% mortality” (even up to 15%), Death is more likely among kids.

The West African strain, on the other hand, is less severe, has a case fatality rate in about 1% of cases.

It’s not immediately known what strain is found in the countries with reported cases, though the UK cases have been reported as the West African strain.

While epidemiology experts say monkeypox usually is “extremely rare”, the US CDC has expressed concern over the surge in transmission and warned that the UK outbreak could spread — alongside the Portugal and Spain outbreaks.

“It is so unusual. Yet I see people saying it’s nothing, just like the flu. Do we never learn to follow new data?” said Harvard epidemiologist Dr Eric Feign-Ding.

Monkeypox electron microscope
This 2003 electron microscope image made available by the Centres for Disease Control and Prevention shows mature, oval-shaped monkeypox virions, left, and spherical immature virions, right, obtained from a sample of human skin associated with the 2003 prairie dog outbreak. Image Credit: AP

How can you get infected with monkeypox?

The virus enters the body through:

• Broken skin (even if not visible)

• Respiratory tract, or the mucous membranes (eyes, nose, or mouth)

• A bite by an infected animal

• Touching its blood, body fluids or fur.

• Eating meat from an infected animal that has not been cooked properly could expose a person to the virus

• Touching clothing, bedding or towels used by someone with the rash.

• Touching monkeypox skin blisters or scabs, or getting too close to coughs and sneezes from an infected person.

It is thought to be spread by rodents, such as rats, mice and squirrels. Key point: Human-to-human transmission is possible.

Is monkeypox virus airborne?

Previous studies state monkeypox is airborne — and stable for up to 90 hours, which could mean it’s infectious during that period (3.75 days).

“Monkeypox is likely aerosol airborne,” said Harvard epidemiologist Dr Eric Feigl-Ding, citing a 2012 study published in the Journal of Virological Methods.

“I pray we’ve learned our lesson with #COVIDisAirborne and don’t repeat the droplet vs airborne 2-year nonsense.”

Test tubes labelled "Monkeypox virus positive and negative" are seen in this illustration taken May 23, 2022. Image Credit: Reuters

Are there drugs or vaccines specifically against monkeypox?

Currently, there’s no monkeypox-specific drugs or vaccines. In the past, smallpox vaccines had been used to curb monkeypox viral transmission.

Is mass vaccination needed?

WHO is not recommending mass vaccination at this stage. "However, we must ensure that we are ready should the need arise," the global health body said.

WHO has said it is creating a new vaccine-sharing mechanism to stop the outbreak of the disease in more than 30 countries beyond Africa.

Was there a previous outbreak of monkeypox?

In 2003, a monkeypox outbreak was recorded in the US. It was traced back to imported exotic animals. In that outbreak, 71 people in 6 US states contracted monkeypox.

Is there a common pattern of transmission?

It's not clear yet as to how people in those clusters in four continents were exposed to monkeypox.  CDC is urging healthcare providers to be alert for patients who have rash illnesses consistent with monkeypox, regardless of whether they have travel or specific risk factors for monkeypox and regardless of gender or sexual orientation.