Reacción a "Reactions to suspected cases of monkeypox in Spain"

Monkeypox was first identified in humans in 1970. In 1980, smallpox was declared eradicated in humans. A virus distinct from the smallpox virus, but closely related, of the same genus orthopoxvirus, had already been observed to be present in Central and West Africa.

There are sporadic cases, mostly in Africa, in hundreds of people every year. Sporadic cases have occurred several times in the USA and the UK, and are now appearing in other countries such as Spain.

If the virus is the Congo virus, it can cause a 10% mortality rate in infected people. It is more lethal than the West African virus, which has a lethality rate of 1%.

The concern would be greater if we had nothing to defend ourselves with, but we do have something to defend ourselves with. In the WHO, of which I am a member of the advisory committee, we meet every year to look at monkeypox cases and the possibility of the risk of human smallpox cases in the event of bioterrorism. We have two WHO-approved centres for human smallpox: one is in Russia and one is in Atlanta. What we do in this committee is to assess what research needs to be done with the smallpox virus to better protect us in case something might happen.

The defence procedures against human smallpox virus are the same as those against monkeypox because the disease is very similar in terms of the spread of the virus, the infection via the oropharyngeal, nasal route, in humans. Then the virus goes through the lymphatic system to different organs: spleen, liver, kidneys... it infects most of the organism, then it goes back again to the blood and manifests itself in the external parts of the skin: extremities, trunk and face.

It spreads by contact, body fluids, respiratory tract, in the form of particles... It has many forms of transmission, but it is not as transmissible as SARS-CoV-2 or influenza.

Logically we have to defend ourselves. Thanks to the monitoring that is done every year, we can say that we have vaccines against monkeypox. There is a recently approved vaccine that has proven effective against monkeypox. We also have two FDA-approved antivirals against human smallpox: tecovirimar and brincidofovir, with two different modes of action.

We have rapid diagnostic methods and we have antivirals and vaccines. The population should be reassured that we have the tools to fight this virus. It is important to convey to society that we are prepared to fight this virus if it spreads further in the population. It is important to transmit peace of mind and that the population feels protected because thanks to science we have been able to generate strategies to control this virus. The viruses are with us and we have to maintain vigilance for rapid diagnosis, follow-up and the necessary research to improve its control and treatment.