The current monkeypox virus is spreading faster than any other in recent history, but Washington State University virologist Heather Koehler sees no reason for the virus itself to spread so rapidly.
An expert in virus interactions with its host, Koehler is researching the strain of monkeypox that is currently circulating, and is working to understand the genetics of the virus by studying its DNA sequences and proteins.
“There are no significant new mutations that can explain the change in transmission,” Koehler said. I am not an epidemiologist. I don’t want to predict how or where we should get vaccinated, but something is not there.”
It could be containment strategies not being implemented appropriately or aggressively enough, or infected people not recognizing symptoms and seeking treatment in a timely manner, Koehler said.
Outbreaks in the past were relatively small and were quickly contained. But this time, the virus had spread to more than 16,500 cases as of late July, most of them in countries where no cases of the virus had been reported.
However, little has changed in the monkeypox genome, Koehler said. While it is possible that a small change can lead to the spread of the disease, researchers have not found any obvious changes that appear to have such a large effect. The analysis showed there were fewer than 100 out of more than 197,000 nucleotides, a type of DNA base pair, that differed in the current virus from those in a smaller outbreak in 2017 in the UK.
“It’s pretty much the same virus,” she said.
Kohler studies virus-host interactions at molecular levels. She was investigating how human proteins interact with the proteins of the now circulating monkeypox strain of West African origin.
This area is considered endemic for this monkeypox virus, which means it has animal species that serve as a reservoir for zoonotic diseases that can be transmitted from animals to humans. It is not uncommon to find cases there. In the past, non-endemic countries have seen cases associated with travel to endemic countries, non-traditional animal hosts, or human-to-human spread. Koehler said the current outbreak appears to be based primarily on human-to-human transmission.
The scale of the current outbreak caused the Director of the World Health Organization to cancel a panel of advisors on July 23 to declare monkeypox a global health emergency. On July 28, the White House announced the first phase of the National Monkeypox Vaccine Strategy In the United States, Koehler is pleased to see these urgent steps have been taken.
“The widespread nature of this outbreak is unprecedented.”
Heather Koehler, virologist
Washington State University
“This is something that is spreading faster than any virologist would have expected based on previous outbreaks that were quickly contained,” she said. “The widespread nature of this outbreak is unprecedented.”
There have been many situations in the past where people traveling to endemic areas have returned, but these have been contained by isolating and vaccinating contacts. Several countries have stockpiles of the vaccine, including the US Centers for Disease Control and Prevention, which has distributed doses to severely affected areas, such as King County in Washington state. However, the response was not sufficient to stop the spread.
One of the problems, Koehler said, might be that people didn’t recognize that they had been exposed to monkeypox. The disease has an incubation period, but people are usually not contagious until symptoms appear. Symptoms include fever, muscle fatigue, and severe headache, but skin lesions are a telltale sign of the virus.
“The lesions are very distinct or distinct. There is not much room for interpretation,” Kohler said. For example, monkeypox lesions can appear anywhere on the body including the palms of the hands and the soles of the feet — unlike lesions caused by other diseases such as herpes or Chickenpox.
Koehler also fears that a misinterpretation of the disease as being spread primarily by men who have sex with men is making the problem worse. Monkeypox can be transmitted through any type of close contact, including handshakes or hugs. Recently, two cases were identified in children, which is a worrying sign because children and pregnant women are among the most vulnerable to the worst effects of the disease.
There is nothing in this virus that targets any particular community, Koehler said, noting that viruses sometimes appear in a particular community simply because they are a tight-knit group of people who interact regularly.
Koehler said the way some media outlets talk about monkeypox is not only biased and inaccurate, but may also prevent people from seeking medical attention.
“We should not put any kind of label on a disease transmitted by contact,” she said. “It doesn’t matter your sexual orientation; it doesn’t matter what kind of physical involvement you’re exposed to – if you’ve been in long-term physical contact with an infected pest, you have the potential to catch it.”