‘There’s no reason why she won’t arrive in Brazil’, says virologist about monkeypox

In the last week, the world followed a rapid growth in the number of cases of apepox, or monkeypox, mainly in European countries. The virus, however, has already spread across the continents of North America and Oceania. The number of confirmed diagnoses and suspected cases exceeds one hundred.

According to virologist Camila Malta, a researcher at the Medical Investigation Laboratory at the Hospital das Clínicas at FMUSP (Faculty of Medicine at the University of São Paulo) and at the Institute of Tropical Medicine, no country is free from having cases.

“There’s no way to predict anything, but there’s no reason why she won’t arrive in Brazil. It is not possible to know which South American country it will enter through, but we know that it has great connectivity through São Paulo, Brasília and Rio de Janeiro. It is possible that it comes from countries with cases through this route. But it’s just a guess.”

She adds: “The WHO [Organização Mundial da Saúde] called an urgent meeting to define if it is an emergency situation. Given this, there is no way for us to think that Brazil is safe, no country is safe”.

What is strange among health authorities is that, at other times when monkeypox cases emerged outside African countries, where the disease is endemic (it usually occurs), the outbreaks were localized. Now, transmission is faster and there are already cases of community spread.

“It’s a disease that wasn’t supposed to be so easily transmitted, because its natural host is not human, it’s probably a rodent. Although it is the simian disease, the most natural host is believed to be a rodent”, says Camila.

One of the possibilities studied is that the virus has undergone a mutation that facilitated transmission between humans.

“The first genomes were sequenced in Portugal, it is still under analysis, so we cannot say anything. Could it have undergone some mutation that facilitates human-to-human transmission, and so are we seeing this outbreak now? It is not yet known, but it is a hypothesis”, he emphasizes.

In the first report of genome analysis carried out in Portugal, the researchers stated:

“A first rapid phylogenetic analysis of the genome sketch indicates that the 2022 virus belongs to the clade [ramo] from West Africa and is most closely related to the virus associated with the export of monkeypox virus from Nigeria to several countries in 2018 and 2019, namely the United Kingdom, Israel and Singapore. These preliminary data and analyzes will soon be updated with the release of new genome data, which will be important in elucidating the origin and international spread of the currently circulating virus.”

Unlike what happens with Sars-CoV-2, which causes Covid-19, the smallpox virus does not undergo rapid mutations, as it is DNA – the coronavirus is RNA.

Fabian Leendertz of the Robert Koch Institute described the outbreak as an epidemic.

“However, this epidemic is very unlikely to last long. Cases can be well isolated by contact tracing, and there are also effective drugs and vaccines that can be used if necessary,” he said in an interview with the Reuters news agency.


Apepox is transmitted through prolonged contact or by sharing clothes, bedding, and towels between a healthy person and an infected person.

“When we talk about clothes, it’s a fact. Smallpox has these pustules, so all material and clothing that the person comes into contact with becomes contaminated. Only it is an airborne virus, but not by small droplets, as is Covid-19. In the case of poxvirus [família desse tipo de patógeno]it needs more, a large droplet, which has to be a kiss or talking very closely for a long time, to increase the chance of this transmission”, highlights Camila Malta.

The incubation period of the disease can be from 5 to 21 days, but the virologist explains that transmission occurs from the first symptoms of the disease, which are not the wounds on the skin, the main mark of smallpox.

“This disease will not always manifest pustules, so it can be completely benign, and the person only has a feverish state. Now, for example, we are in a harsh autumn in Brazil; a person appears with a headache, fever, skin rash [erupções na pele], muscle pain, you will think of dengue, Covid. Until she has the dermatological manifestation, she has already transmitted the virus”, he warns.

For human-to-human transmission to occur, the “virus needs to be replicating, and the person needs to be showing a symptom, even if it’s mild”, he says.

“She has to be sick, but not necessarily with a pustule manifestation. One person can have a severe headache, another can have dermatological manifestations, and another person doesn’t feel anything, and all three are transmitting it.”

One of the news that reassure health organizations is that the disease tends to be mild and have a much lower lethality than traditional smallpox, which has been eradicated worldwide with the help of vaccines. According to the WHO, these immunizers are around 85% effective against monkeypox.

There is also an antiviral drug, approved for use in the United States, to treat the disease, Tpoxx (tecovirimat). However, in general, what you do is control the symptoms and wait for the eruptions to clear up.

For all this, the researcher says she believes that the control of this outbreak tends to be faster.

“The hope is that this does not become an emergency like that of Covid-19, but I don’t think it’s such an optimistic scenario, since every day a new country detects this virus. However, we have the technology to build vaccine vectors, vaccine skeletons much faster than we believed we were capable of. Although it is worrying, it is better than it would have been 20 years ago to control this new outbreak”, he concludes.

In Europe, the concern is that the summer holidays could increase the size of the outbreak if there is no control of transmission in the coming weeks.

“As we enter the summer season in the European region, with mass gatherings, festivals and parties, I am concerned that transmission could accelerate as currently detected cases are among those who engage in sexual activity and symptoms are unknown to many.” , said the head of the European division of the WHO, Hans Kluge, in a statement.

For the UKHSA (UK Health Safety Agency) chief medical consultant, Susan Hopkins, an increase in the number of new diagnoses is expected.

“We anticipate that more cases would be detected through our active case finding across NHS services. [Serviço Nacional de Saúde do Reino Unido] and greater vigilance among health professionals. We believe that this increase will continue in the coming days and that more cases will be identified in the community at large. In addition, we are receiving reports of other cases identified in other countries around the world.”

About Jenni Smith

She's our PC girl, so anything is up to her. She is also responsible for the videos of Play Crazy Game, as well as giving a leg in the news.

Check Also

Pacheco says that the Senate will vote for the ANS in August

President of the House says that proposal on health plans will still be debated; government …