One important note with mpox is that there are two distinct lineages of the virus at play: the outbreak in the US in 2022 was clade IIb, which seems to be difficult to spread - hence the “close physical contact” attribution. It also had a low observed CFR.
Clade I mpox is the current outbreak under discussion. It spreads far easier - most pathways are likely not sexual contact - and has an observed CFR 10x higher than IIb.
In other words: this is a very different virus than what we saw in 2022.
Civil war, foreign military incursions, mass population displacement, famines, warlordism might explain some of the medical challenges on the ground.
Add to that uncontrolled mining, forest cutting and extractive industries, reserves of in-demand “mobile phone” minerals, and the warlords: unprecedented contact between displaced populations and displaced and under pressure wildlife and you’ve got great opportunities for animal-to-human disease transmission, above and beyond the basic human-to-human kind.
It’s a humanitarian and ecological catastrophe and we’re all just plugging our ears saying “La la la” or “is hygiene especially bad over there?”.
A mix of rapid urbanization and wild animal consumption (either as bushmeat or traditional medicine) as well as wetmarkets [0]
> Why not Brasil or India
Brazil has developmental indicators comparable to China and Mexico so I wouldn't put it in the same bucket as India.
And, Brazil and India actually aren't that dense - they are both much more small town driven due to the constraints of democracy.
A mega city like São Paulo only gets 30% of the deputies of the entire state of São Paulo, meaning smaller towns and rural areas get higher priority. And in India, a megacity like Bangalore only gets 13% of all MLAs in the state of Karnataka.
This made megacities much less attractive to migrate to compared to T2/3/4 cities in both countries.
Also don’t forget the vast majority of genetic diversity in homo sapiens is found in subsaharan Africa
Much potentially vital genetic information can be found in the Congo, but also more “attack vectors” for novel pathogens
The DRC specifically is packed full of heterogeneous ethnic populations with varying levels of ethnic mixing, on the scale of 100-250+ distinct genetic groups
These groups often have higher genetic diversity between them than all “white” peoples globally
Diversity on the whole is a good thing, but can be dangerous in potentially hazardous environments (such as the close, effectively forced daily animal contact you’d find in the DRC)
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This also applies to other mammals, eg why you see so so many Bat-bourne illnesses, as they have by far the most genetic diversity of any mammal group
We have these harmless fruit bats here in Australia, but friends and family are sometimes startled when I tell them off for approaching injured or dead bats. Alive or dead they’re extremely hazardous to humans - even placid ones
> Much potentially vital genetic information can be found in the Congo, but also more “attack vectors” for novel pathogens
I don't think it quite works that way. At least, I only ever hear about a lack of genetic diversity being a threat in the context of diseases and immunity (usually in the context of domesticated animals and cloned plants, like bananas). And there the argument is that once a virus has way in, it can spread to everyone else genetically similar enough.
So I think this is mixing up two views: one takes all genetic variation out there, and asks "if I were to unleash this novel virus on all of them, would any of them be infected?" The higher the diversity, the higher the chance that at least one happens to have the genetic make-up that is accessible by a virus.
But the actual questions are closer to "how many would be infected? How easy would the virus spread?" In that case I would expect higher genetic diversity to result in lower numbers. Like a kind of soft herd-immunity in diversity.
I'm not an expert though, so if anyone who does know their stuff in this matter could weight in that would be appreciated.
Also, as far as I understand the problem for bats is that they share (predigested) food with their fellow bats in their colonies. So if one is sick with anything, all of them will be exposed.
I know almost nothing about genetics or virology, but perhaps GP is saying the close proximity of genetic similarity allows viruses to mutate and infect people it otherwise wouldn’t. For example, say Person A had a virus, and under no circumstances would Person A ever infect Person C due to Person C being just barely genetically different enough from A. Then we put Person B into the mix who is “halfway between A and C” (quotes because that’s probably not precisely how genetics works, but I don’t know). The virus infects B, then mutates and infects C.
In case of ebola, fruit bats[1] or other bushmeat (chimpanzee, antelopes which can have eaten fruit bats infected fruits) have been suspected mode of transmission.
Usually eating them is safe because they are smoked/cooked but the people hunting and preparing them can be infected in the process and transmit to others.
Monkey pox was originally called that because the first variant was observed in a lab monkey. Its primary site of infection was not monkeys, actually, and it travels between people fine.
We already have effective vaccines. The virus is spread through close contact, contaminated clothing, sheets or surfaces, consumption of contaminated meat and sexual contact. It's not going to be like COVID.
Or, the challenge will be convincing anyone to take it now that distrust of vaccines is at an all time high, due to the reckless speed at which we implemented the covid vaccines; and admittedly the very real myocarditis and autoimmune disorders it causes. Combined with increased political polarization.
And, the misinformation surrounding the link to autism that turned out to be fabricated by a scientist who just wanted to be famous. Or, that time a company 'accidentally' sent the hpv vaccines to South America that included the highly undesirable side effect of sterilization that had already caused the vaccine to be banned from use state-side. Or, that time we weaponized the distribution of vaccines in Pakistan to find Bin Laden more quickly.
Note: I'm not a vaccine denier or avoider, but I think we need to be honest with ourselves with what the actual challenges are and why they exist.
> due to the reckless speed at which we implemented the covid vaccines
There was nothing "reckless" about the speed of the vaccine development. That's just a fear-based reactionary thing, with no basis in any sort of fact or objective measure.
> the very real myocarditis and autoimmune disorders it causes
Both of which are far lower risk than the risk of myocarditis or long-term immune system damage caused by Covid infection.
The anti-vaccine arguments are the same as when seatbelts and airbags were new, and there was a vocal cohort highlighting the injuries caused by seatbelts, ignoring the fact that the injuries would have been 10x without them.
If 10,000 unvaxxed people get Covid and 1,000 of them get heart damage from the disease or 10,000 people get vaccinated and 1 of them gets heart damage from the vaccine, it's still obviously better to have gotten the vaccine for the general population.
"During the 2022–2023 global outbreak of clade II, transmission between people was almost exclusively via sexual contact".
But saying you can't be sexually promiscuous is a quick way to be down d00ted here.
bUt wE hAvE vAcCiNeS
71.8% effective which means you have a 29% chance of STILL catching it and it's only good for 2 years so those who got jabbed up during the last out break need to be re-upped.
Hate all you want down d00ters, the moral of the story is: don't have lots of anonymous gay sex partners. It's not homophobic to point out that fact that MSM groups have the highest rates of STDs. They have it for a reason.
the Mpox vaccine is also supposed to be effective against smallpox. There's been no generally available protection against that for decades, til this popped.
I'm really surprised the panic mongers have not been using the relationship between "pox" diseases to heighten the hype. Saving that for later?
Clade I mpox is the current outbreak under discussion. It spreads far easier - most pathways are likely not sexual contact - and has an observed CFR 10x higher than IIb.
In other words: this is a very different virus than what we saw in 2022.
https://centerforhealthsecurity.org/sites/default/files/2024...