After a sigh over COVID-19, 'Wonsungi-dujang'... Why Scientists Are on High Alert [Reading Science]

Monkeypox symptoms. Photo by Yonhap News Agency

[Asia Economy Reporter Kim Bong-su] The monkeypox infection outbreak, which is unusually spreading globally, is causing concern among scientists. As the COVID-19 pandemic begins to subside, researchers are focusing on why monkeypox, a disease that emerged around this time, has broken regional boundaries to spread to dozens of countries, whether genetic mutations have occurred, if this outbreak can be controlled, and how it differs from previous cases.

◇ Increasing Number of Patients

Since the UK health authorities identified the first patient three weeks ago, the monkeypox outbreak has been spreading. According to the international scientific journal Nature, over 400 confirmed or suspected cases have been reported in more than 20 non-African countries including the UK, Spain, Portugal, Canada, and the United States. Scientists and health authorities worldwide are on high alert due to the simultaneous emergence of infections in multiple countries among separate population groups, the lack of clear epidemiological links between regional clusters, and the high likelihood of regional virus transmission.

The World Health Organization (WHO) collected virus samples from infected individuals in Germany, France, Belgium, Portugal, and the United States after the initial outbreak confirmation. The results showed that these monkeypox viruses are very similar to those previously identified in West Africa. Fortunately, this type of monkeypox virus has a fatality rate below 1%, much less deadly than the Central African strain, which exceeds 10%. It was also confirmed that these viruses share the same nucleotide sequences as those found in people who traveled to West Africa in 2018-2019. Bernie Moss, a researcher at the U.S. National Institute of Allergy and Infectious Diseases, explained, "Simply put, it can be analyzed that someone was infected with the monkeypox virus while visiting West Africa and then spread it to others." Another analysis comes from Gustavo Palacio, a researcher at Mount Sinai School of Medicine in New York, who said, "It cannot be ruled out that the monkeypox virus has been silently circulating between animals and humans outside Africa." However, this hypothesis is considered unlikely because monkeypox causes visible skin symptoms that are promptly reported by medical personnel.

On the 27th, passengers arriving on a flight from Europe at Incheon International Airport Terminal 1 are waiting to undergo quarantine for overseas infectious diseases such as monkeypox. Photo by Mun Ho-nam munonam@

◇ Possibility of Virus Mutation?

So why has monkeypox suddenly started spreading across continents? Scientists suspect the possibility of genetic mutations but face difficulties in research. Even though it was confirmed 17 years ago that monkeypox viruses are divided into two types?West African and Central African?with distinct differences, the exact reasons at the genetic level remain unclear. Rachel Roper, a virology professor at East Carolina University, explained, "The genome of the monkeypox virus is much larger than that of many other pathogenic viruses. It is more than six times larger than the COVID-19 virus," adding, "This means analyzing the genome is more than six times harder." There are also practical limitations due to poor medical and health conditions in Africa, which have hindered proper research on the monkeypox virus. Professor Palacio said, "To confirm whether the monkeypox virus has mutated, it is necessary to go to Africa and collect virus samples from host animals such as squirrels or rodents and analyze their nucleotide sequences. However, no one has conducted such research yet."

◇ Can Large-Scale Infection Be Prevented?

Following the monkeypox outbreak, some countries including Germany have started purchasing smallpox vaccines known to be effective. The U.S. Centers for Disease Control and Prevention (CDC) stated that receiving the smallpox vaccine within four days after exposure to the monkeypox virus can prevent disease onset. Accordingly, the U.S. government is considering vaccinating healthcare workers treating monkeypox patients with the smallpox vaccine.

What is more concerning is the possibility of the monkeypox virus spreading to animals in Europe and North America. If this happens, humans and animals in those regions could become hosts, allowing the virus to establish itself and become endemic. The European Centre for Disease Prevention and Control (ECDC) noted this possibility on the 23rd but currently assesses the risk as low. European health authorities are urging that pets capable of transmitting the monkeypox virus, such as guinea pigs and hamsters, be isolated and monitored separately.

Monkeypox virus.

◇ Has It Become a Sexually Transmitted Disease?

Reports that the current monkeypox virus infections spread internationally through gay parties held in Spain and Belgium have fueled such suspicions. The virus is originally known to spread through close contact with lesions, bodily fluids, or respiratory droplets of infected people or animals. However, Ann Limoin, an immunology professor at the University of California, said, "Just because some patients were infected through sexual activity does not mean the virus has become more contagious or sexually transmitted." She explained, "This virus spreads easily through close contact. Unlike COVID-19, which dies quickly on surfaces or skin, this virus can survive longer and spread via bed sheets or door handles." Regarding the association with homosexuality, she said, "The general analysis is that the virus happened to enter the gay community and has been spreading continuously."

Meanwhile, as countries worldwide lift the strict COVID-19 control measures, experts are concerned that other infectious diseases, previously suppressed by these measures, are now emerging unexpectedly, as seen with the monkeypox outbreak. According to the U.S. scientific journal STAT, hospitalization rates due to adenovirus type 41, which causes influenza-like symptoms, are soaring despite it being May. This disease typically spreads in winter and causes severe hepatitis in children. Similarly, respiratory syncytial virus (RSV), which mainly spreads in winter, widely circulated in the U.S. and Europe last summer and early fall.