Monkeypox: Health ministry confirms only one person contracted virus

Another person who was suspected of having monkeypox was eventually cleared from having the disease, bringing the tally of confirmed cases back to one.

 An electron microscopic (EM) image shows mature, oval-shaped monkeypox virus particles as well as crescents and spherical particles of immature virions, obtained from a clinical human skin sample associated with the 2003 prairie dog outbreak in this undated image obtained by Reuters on May 18, 2022 (photo credit: CYNTHIA S. GOLDSMITH, RUSSELL REGENCY/CDC/HANDOUT VIA REUTERS)
An electron microscopic (EM) image shows mature, oval-shaped monkeypox virus particles as well as crescents and spherical particles of immature virions, obtained from a clinical human skin sample associated with the 2003 prairie dog outbreak in this undated image obtained by Reuters on May 18, 2022
(photo credit: CYNTHIA S. GOLDSMITH, RUSSELL REGENCY/CDC/HANDOUT VIA REUTERS)

A suspected second case of the monkeypox virus has been detected in an Israeli who recently returned from West Africa, the Health Ministry reported on Sunday morning.

The first case of the disease in Israel was reported on Friday night, amid a largely Europe-centered monkeypox outbreak of close to 100 cases, and confirmed a day later following diagnostic tests. In both instances, the patients are reported to be in mild condition and doing well.

The Health Ministry has been quick to reassure the public that Israel is not dealing with a second COVID-19-style pandemic, with Health Minister Nitzan Horowitz taking to Twitter, explaining that “this is a disease, not a pandemic.”

“This is a known disease with, usually, light symptoms. [It] is not similar in any way to the coronavirus,” he wrote, adding that the ministry is prepared to deal with monkeypox, whatever shape a possible outbreak takes.

Monkeypox is one of several diseases grouped under the family of viruses known as Poxviridae, the most well-known of which is smallpox. Although there are several similarities between the two diseases, monkeypox is known to be far less contagious and less severe. However, they are still similar enough for the approved smallpox vaccine to be effective against it.

Prof. Nachman Ash, Israel's Health Ministry director-general. (credit: HEALTH MINISTRY)Prof. Nachman Ash, Israel's Health Ministry director-general. (credit: HEALTH MINISTRY)

In fact, Clalit Health Services infectious disease expert Dr. Ian Miskin told The Jerusalem Post that the success of the smallpox vaccine in protecting against monkeypox might be the reason why monkeypox infections appear to have increased in recent years.

“We know that the old smallpox vaccination protected against monkeypox, which is why we didn’t see it for years, because it didn’t infect people who had been vaccinated against smallpox,” he explained. “But we stopped vaccinating [against smallpox] in the 1980s, which means people under the age of 40 would not have received the vaccine.

“And as this age group makes up more and more of the population, it is probably why we’re seeing it arrive in Europe now, as people who have been to Africa have been infected and can then infect others.”

However, the solution isn’t as simple as reintroducing the smallpox vaccine, he said, and there are currently no plans for any sort of large-scale vaccination drive. Although it is effective when administered in large quantities, if not enough people receive the smallpox vaccine, the virus can actually begin to spread as a result of the live virus in the vaccine, making vaccination a less than desirable solution. Additionally, it can have quite severe side effects, and the severity of them is not warranted by the relatively mild monkeypox strain.

There are several drug treatments that have proven to be effective against monkeypox, though, making them a viable alternative to the administration of the smallpox vaccine.

“However, their side effects are liable to limit [their administration],” Miskin explained, “especially when we are talking about a disease that is not life-threatening in the Western world as far as we can tell.”

This does not mean that no plans are in place in the event that the severity of the outbreak increases and the need for treatment becomes more necessary.

Supporting Horowitz’s statement that the Health Ministry is preparing for all eventualities, Miskin said, “The Health Ministry isn’t asleep. They are actually seeing what they can do about getting a new version of the vaccine if necessary, especially for hospital workers and people who have to be in close contact with the disease.”

Monkeypox can be transmitted in several ways, one of which is through droplet transmission. Although this is perhaps the most well-known way in which the virus spreads, it is certainly not the most efficient one.

The most efficient way for the virus to spread, explained Miskin, is through direct physical contact.

“Because the scabs and wounds are full of virus particles, we see infection spread from lesion to lesion, or lesions to bedding, and so somebody who is in contact with these patients, even if they just have the beginning of a lesion developing, is liable to be infected,” he said, adding that this seems to be the main cause of the current outbreak.

When it comes to the progression of the disease transmission, Miskin said the speed at which the virus either disappears or spreads over the next few weeks will be determined by the behavior of those most liable to spread it.

“We’re looking for self-discipline,” he said. “If people in Europe realize that there are people at high risk [for spreading it], and if these people make sure they do not infect others, I expect this will go away pretty fast.

“However,” he continued, “If people don’t act responsibly despite being liable as a high risk and being liable to have been in contact [with the disease] in the last 12 days, then I think we may be in for an outbreak.”