Monkeys and Monkeypox: Are we on the brink of another stigma?

Historical background

The most recent multi-country outbreak is monkeypox (MPX) which has infected 45618 confirmed cases in 95 countries worldwide, as of August 25, 2022 [1]. In this regard, MPX was declared a public health emergency of international concern (PHEIC) by the World Health Organization (WHO), as of July 23, 2022 [2]. MPX is a zoonotic disease, caused by the monkeypox virus (MPXV) which is a member of the Orthopoxvirus genus in the family Poxviridae [3].

In 1958, the MPXV was found in a colony of monkeys in Copenhagen of Denmark [3]. In 1970, the first patient with MPX was identified in the Democratic Republic of the Congo (DRC). Since 1970, human MPX cases have been reported in 11 African countries. These countries are Benin, Cameroon, the Central African Republic, DRC, Gabon, Cote d’Ivoire, Liberia, Nigeria, the Republic of the Congo, Sierra Leone, and South Sudan [4].

In 2003, the first MPX outbreak that occurred outside of Africa was in the USA. This outbreak led to over 70 MPX cases in the USA. MPX has also been reported in travelers from Nigeria to Israel in September 2018, to the UK in September 2018, December 2019, May 2021, and May 2022, to Singapore in May 2019, and to the USA in July and November 2021. In May 2022, multiple cases of MPX were identified in several non-endemic countries [4].

Signs and symptoms

Rash in the hands, feet, chest, face, or mouth, near the genitals (penis, testicles, labia, and vagina) or anus (butthole). The Rash looks like pimples or blisters initially. People may experience all or some symptoms such as fever, chills, swollen lymph nodes, exhaustion, muscle aches and backache, headache, and respiratory symptoms (e.g., sore throat, nasal congestion, or cough). Symptoms start within 3 weeks when one gets exposed to MPXV. Symptoms may last from 2 to 4 weeks [5].

Ways of transmission

MPXV transmits either directly or indirectly from infected animals or humans to humans through broken skin (e.g., bites or scratches), respiratory droplets, bodily fluids, or infected pox lesions (sores). Also, MPX can spread through contact with contaminated materials such as clothing or bedding. The distinctive feature of the recent multi-country MPX outbreak is transmission via the community of men who have sex with men (MSM). However, it is under study [3].

Monkeys and monkeypox, stigma, false information, and its dangerous implications on monkeys

MPX has received its name “monkeypox” because MPXV was first found in monkeys. Due to this reason, the literature, and the name itself have been creating dangerous implications for monkeys. People are killing monkeys by poisoning them, and this creates a bad impact on our environment because monkeys are very important for keeping our ecosystem healthy. Monkeys help in the regeneration of degraded tropical rainforests. Moreover, monkeys help in growing trees and shrubs as well as pollination of flowers [6]. Recently, WHO has discovered that MPXV is not linked to monkeys. The virus has been found in many other non-human primates as well. WHO has stressed that the recent multi-country MPX outbreak is not linked to monkeys.

Margaret Harris, A member of WHO, has told in an interview that monkeys are not the main transmitters of MPX. They have no role in the outbreak. She has further added that MPX received its name because the virus was first identified in monkeys kept for research in Denmark. She also has added that this virus is present in many animals. Harris also has advised everyone to not attack any animals and maintain proper precautions for protecting themselves from MPXV. Because it can destroy our ecosystem, she has said that the recent global explosion of cases was due to close-contact transmission between humans [7].

Recommendations and solutions

Some recommendations and solutions are discussed below. It will help to protect humans from getting infected with MPXV and save monkeys to some extent. It is utmost to increase public awareness about the different aspects of the ongoing multi-country MPX outbreak such as the main transmitters, ways of protection, and prevent attacks against monkeys is paramount. Monkeys play a great role in the ecosystem and help in the process of seed dispersal of plants. However, individuals should avoid contact with infected cases either animals (especially sick or dead animals) or humans, bedding and other materials contaminated with the virus, Cooking all foods thoroughly that contain animal meat or parts, and Washing hands frequently with soap and water before touching and after touching any things alongside with disinfection any contaminated subjects, seeking the healthcare when getting infected with MPXV, and finally vaccinating animals to reduce infection with the virus [8].

Researchers have a fundamental role in this by conducting more research studies to determine the main transmitters behind the recent surge of MPX globally and ways of protection against infection with MPX and to attenuate the stigma against monkeys to save the life of a fundamental element of our ecosystem.

Ethical approval

N/A.

Sources of funding

None.

Author contribution

RAF: designed the study. RAF and AKMSK: made the first draft. RAF: updated the manuscript. RAF: reviewed the final draft and edited final. All authors have critically reviewed and approved the final draft and are responsible for the content and similarity index of the manuscript.

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Guarantor

All authors.

Consent

N/A.

Declaration of competing interest

None declared.