The advance in the number of cases of monkeypox around the world has started a race of scientists to understand what is happening with the monkeypoxthe virus that causes the disease, so that it has acquired a greater power of infection among humans.
Portuguese scientists published yesterday (23) a new genetic analysis on the specialized website Virological, in which they claim to have found “genetic divergence and first signs of microevolution”. This indicates that the first mutations were noticed in the virus – which help the unprecedented speed of current spread.
So far, however, experts still consider the chance of uncontrolled transmission to be low. In addition, according to the WHO (World Health Organization), vaccines used during the smallpox eradication program help protect against monkeypox.
In all, according to the researchers, 50 genetic changes were found in relation to the initial West African virus. As the power of these changes is not yet known, it is necessary to wait for the behavior of the spread of the disease in the coming days to understand its impact.
“By the standards of a virus, the genome is huge, it’s almost 200,000 nucleotides. So that number  does not trigger a special alert”, says virologist Fernando spilki, Psquire in the area of viral mutation. “These are situations that may even prove to be important over the next few weeks, but everything is still being evaluated as the facts evolve”, says the specialist, what is a professor at the University fee (RS) and member of the Temporary Technical Chamber of the MCTI (Ministry of Science, Technology and Innovation) to monitor the monkeypox.
At this beginning, in which most cases may be related to isolated transmission events, these data can help us to understand how transmission chains occur, where the virus comes from and how it will be distributed in countries.
Last week, another study found that the virus that is infecting people in Europe today is more closely related to a virus associated with the export of monkeypox from Nigeria to various countries in 2018 and 2019.
“This virus that is in Europe belongs to this clade [grupo de monkeypox] which is considered less virulent. There are two clades, and the most virulent is the one in the Congo basin”, points out the virologist and poxvirus specialist, giliane Trinity.
The sequences of the study published yesterday were obtained from infected patients in Portugal and collected from nine patients on the 15th and 17th of May. “We have already detected the first signs of microevolution within the cluster [grupo] of the outbreak, that is, the emergence of 7 SNPs [Mutações + inserções + deleções, diferenças] leading to three descending branches”, they say.
Among the main conclusions of the analysis is that the outbreak “probably has a single origin”.
High of cases
As scientists study, the number of cases only grows across the planet. In all, 16 countries have already reported suspected or confirmed cases.
Until 6 pm yesterday, 168 cases were confirmed by examination and another 82 are suspected in the world, among them the first in Latin America, in Argentina.
The WHO (World Health Organization) expects more cases of monkeypox to be identified as surveillance expands in non-endemic countries — where the disease is not permanently present. “This can help fine-tune control strategies,” said the entity in a statement released on Sunday (24).
Evidence suggests that they run higher risk those who have had close physical contact with an infected person who shows smallpox symptoms, the organization says. “WHO is also working to provide guidance to protect frontline healthcare workers and other healthcare workers who may be at risk, such as janitors.” The entity says it will provide more technical recommendations in the coming days.
Transmission and symptoms
THE monkeypox It is a virus from the same family as human smallpox and was discovered in the 1950s in animals, mainly non-human primates. “But there are also monkeypox in other rodents and mammals, which can be reservoirs of this virus”, says infectologist Vera Magalhães, professor at Tropical Diseases at UFPE (Federal University of Pernambuco).
The first evidence of human transmission of this virus, he says, occurred in 1970, when smallpox was still circulating in the world. “It occurred in Africa and to this day causes human infection on the continent, mainly in people who have had contact with animals,” he reports.
It is not the first time that an outbreak has occurred outside of Africa. Vera says that, in 2003, about 40 cases were registered in people who had contact with dog breeds that were domesticated in the United States. In turn, these animals had contact with small rodents imported from Africa.
In Africa, the literature says that the disease kills 1 in 10 people. In the US we have more optimistic data, but we do not have this statistic in relevant numbers. It is still difficult to predict exactly what will happen.”
Vera Magalhães, infectious disease specialist
Vera says that the transmission of this virus, unlike the coronavirus, for example, occurs by respiratory droplets, but not by aerosol. “That is, it takes a more intimate contact. It is common in veterinarians and animal caretakers who have contact with some secretion, or when they get a scratch or bite.”
About symptoms, Vera Magalhães says that there is not much difference from smallpox. “The incubation period ranges from five to 21 days, and starts with fever, myalgia [dor muscular]headache [dor de cabeça] —like any infection. In one to three days, the macular rash begins [manchas na pele]then they will turn into papules [espinhas] and then the vesicles [que evoluem para virarem feridas] very characteristic of smallpox”, he reports.