“This isn’t a virus that, as far as we’re aware, would really take off in a population like COVID,” she said. It transmits via contaminated surfaces or prolonged proximity with other people, which is why most outbreaks have been small, and why people have mostly transmitted the disease to either household members or health-care workers. One of them, Andrea McCollum of the CDC, told me that based on existing studies, monkeypox doesn’t spread easily, and not over long distances through the air. COVID was completely unfamiliar when it first appeared, but monkeypox is a known quantity, and experts on the virus actually exist. To be clear, monkeypox isn’t COVID-they’re different diseases caused by different viruses with markedly different properties. Can we better thread the needle between panic and laxity, or will we once again eschew uncertainty in a frantic quest for answers that later prove to be wrong? Monkeypox, then, is a test of the lessons that the world has (or hasn’t) learned from COVID. “I don’t think people should be freaking out at this stage,” Carl Bergstrom of the University of Washington told me, “but I don’t trust my own gut feelings anymore, because I’m so sick of all this shit that I tend to be optimistic.” catastrophically underestimated COVID, many Americans are panicking about monkeypox and reflexively distrusting any reassuring official statements. During the West African Ebola outbreak of 2014, American experts had to quell waves of undue paranoia, which likely contributed to the initial downplaying of the coronavirus. “I don’t think that’s necessarily a good thing.” When it comes to epidemics, people tend to fight the last war. These monkeypox outbreaks are also unique because … well … they’re occurring in the third year of a pandemic, “when the public is primed to be more acutely aware of outbreaks,” Boghuma Kabisen Titanji, a physician at Emory University, told me. (The count is now 11: Since we spoke on Wednesday, monkeypox has also been confirmed in Sweden, Italy, Germany, Belgium, France, Canada, and Australia.) (The incubation period between infection and symptoms is long, ranging from five to 21 days.) “It’s uncommon to see this number of cases in four countries at the same time,” Inglesby said. This suggests that the monkeypox virus may be surreptitiously spreading from person to person, with some number of undetected cases. But several others hadn’t recently been to endemic countries, and some had had no obvious contact with people known to be infected. The first case, which was identified in the United Kingdom on May 7, fit the traditional pattern: The individual had recently traveled to Nigeria. The current outbreaks in Europe and the U.S. Just last year, two travelers independently carried the virus to the U.S. The only significant American outbreak occurred in 2003, when a shipment of Ghanaian rodents spread the virus to prairie dogs in Illinois, which were sold as pets and infected up to 47 people, none fatally.
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Rarely, monkeypox makes it to other continents, and when it does, outbreaks “are so small, they’re measured in single digits,” Thomas Inglesby, the director of the Johns Hopkins Center for Health Security, told me. The virus occasionally spills over into humans, and such infections have become more common in recent decades. Endemic to western and central Africa, it was first discovered in laboratory monkeys in 1958-hence the name-but the wild animals that harbor the virus are probably rodents. The virus behind monkeypox is a close relative of the one that caused smallpox but is less deadly and less transmissible, causing symptoms that include fever and a rash. Ten minutes later, she stopped mid-sentence to say that a colleague had just texted her a press release: “ Massachusetts Public Health Officials Confirm Case of Monkeypox.” “If we see those clusters, given the amount of travel between the United States and Europe, I wouldn’t be surprised to see cases here,” Rimoin, who studies the disease, told me. Yesterday afternoon, I called the UCLA epidemiologist Anne Rimoin to ask about the European outbreak of monkeypox-a rare but potentially severe viral illness with dozens of confirmed or suspected cases in the United Kingdom, Spain, and Portugal.