The sudden appearance of monkeypox outside its endemic regions, in Central and West Africa, surprised the world. Although it was not the first time the virus had broken out elsewhere, the scale of the current health crisis is unprecedented. From the beginning of May to the middle of July, at least 7,665 cases have been reported in the European Union (EU), according to figures compiled by Civio, which is one thousand more cases than the WHO reports . It is the largest outbreak of this virus ever seen in Europe, where few countries were well-prepared.
“No one expected transmission within Europe or the United States, without [a patient] having travelled or their partner or friend having travelled,” says Mar Faraco , president of the Spanish Association of Foreign Health Doctors . For the moment, the most affected countries in the EU are Spain (2,895 cases), Germany (1,859), France (912), the Netherlands (549), and Portugal (515), while the United Kingdom, where the first patients of this outbreak were detected, reported 1,856 cases through mid-July.
Two different, but related, poxes
Monkeypox is caused by a virus similar to the smallpox virus, which the WHO certified eradicated in 1979 . However, while smallpox has accompanied our species for centuries , researchers first confirmed transmission of monkeypox among humans in 1970 . Since then, this monkeypox has gained ground, although without the tragic consequences of smallpox. “The smallpox virus had a 30%, mortality rate and decimated entire populations,” says Esteban, while the monkeypox mortality rate is between 1% and 10%. According to an initial analysis by researchers at the Carlos III Health Institute, the current outbreak seems to be caused by the less virulent variant.
“[That] cases like this occur, which are appearing in different countries, is very striking,” says virologist Mariano Esteban, of the National Centre for Biotechnology (CNB-CSIC). However, he says the situation “is very different” from the beginning of the COVID-19 pandemic , since there are diagnostic tests, antiviral drugs such as Tecovirimat and, especially, vaccines. However, monkeypox has for years been a neglected disease that affected Africa the most, which explains why many European countries lacked adequate means to control this outbreak.
A vaccine as in-demand as it is limited
The majority of detected cases in this outbreak