Keeping Current: Still Much to Learn about Monkeypox

The monkeypox outbreak can inform public health strategy, says Catharine Paules, infectious diseases expert at Penn State Health.

monkeypox virus under a microscope courtesy CDC

“The World Health Organization declared monkeypox a global public health emergency at the end of July due to an increase in nonendemic regions, including the U.S. Containing and eliminating this disease in nonendemic regions is crucial and must be addressed with urgent, globally coordinated efforts. There are still things we don’t know about how monkeypox will play out in the U.S. and around the world.

“Thus far, it has primarily played out in networks of men who have sex with men, but without elimination it will almost certainly cause disease in other communities. In parts of Africa where it is endemic, it has a severe impact on pregnant women, the immunocompromised, and children under the age of 8. Until we see spillover into those populations, severity will be difficult to determine. We also know that one of the reservoirs of the disease is certain rodent populations. Once it gets into animal reservoirs in the U.S., then it will be something we always deal with here.

“The outbreak has also highlighted again the need for public health preparedness. We had a chance to learn about monkeypox long ago because it is endemic in Africa, yet we didn’t take the opportunity to implement vaccination strategies or therapeutics in at-risk populations until it spread out of Africa. We must now implement these countermeasures without optimum data.

“Outbreaks like this are predictable, and illustrate yet again the need to facilitate studies on strategies and therapeutics before outbreaks occur. One problem is a lack of support for preparedness, leaving us scrambling when an outbreak occurs. This is a constant trend and the biggest lesson we can learn from this outbreak.”