This episode is sponsored by OneDrive, a subscription service where you can find the answer to everything you've ever wondered about and some things you never imagined you would wonder about. Head over to onedrive.com SciShow for a free trial [Music] this month May 2022, more than 120 confirmed or suspected cases of a rare disease called monkeypox have been reported in countries like Portugal Spain the UK and the USA This means it is being detected outside its origins in central and western Africa and in multiple unrelated places. That's something that always gets the attention of public health authorities. So what is monkeypox, and why is it popping up now here is what we know monkeypox is a disease caused by a virus that is part of what's known as the ortho pox family, which are brick or oval-shaped DNA viruses in the same family as cow pox and smallpox, though not chickenpox, it typically starts out with flu-like symptoms like fever, chills and muscle aches as well as swollen lymph nodes a few days after the fever sets in, the patient gets fluid-filled bumps on their skin. These tend to be concentrated on the face and extremities, including the palms and soles of the feet. Infections usually last about two to four weeks. And there's an incubation period of often around one to two weeks before symptoms appear. Basically, we know that monkeypox isn't a new disease. Experts have already been studying it for decades. And it is a zoonotic disease, that's one that is spread from animals to humans. It's named monkeypox because it was discovered in research monkeys in the 1950s. The natural reservoir is not known, but its primary host is probably some sort of African rodent. A person might catch it if they get scratched or bitten or if they eat undercooked contaminated meat from their monkeypox can be spread from person to person via contact with contaminated materials like bedding or towels bodily fluids respiratory secretions, or the infectious fluid from the sores the first time it was documented in people was in 1970 in the Democratic Republic of the Congo since then when it has cropped up in humans it's usually been in central and West Africa mostly in rural rainforest regions however cases have been rising over the past couple of decades since 2017 There's been a particularly large ongoing outbreak in Nigeria, for instance, and we've seen some travel related cases outside of Africa. In 2003, there was an outbreak in the U.S. related to pet prairie dogs and imported exotic animals we don't know for sure why outbreaks are becoming more frequent it might be related to people coming into more contact with animals due to changing circumstances and habitat loss. But it may also actually have to do with the death of smallpox, because the smallpox vaccine can prevent monkeypox infection. Remember that smallpox and monkeypox are in the same viral family and up until around 40 years ago, getting a smallpox vaccine was common, but the disease, in a marvelous feat of humanity, was declared extinct in 1980 and since then vaccinations have mostly stopped today. Only around 30 of the people in the world have been vaccinated against smallpox that means over time as smallpox immunity waned monkeypox may have gained more opportunities to infect unprotected people, in fact most of the people who've been infected were not vaccinated for smallpox so that's the run-up but what about the current outbreak that has appeared in Europe and elsewhere outside of Africa unfortunately some of this attention is just because like let's be honest infections are spreading to places that aren't Africa. But it's also a genuine concern because it's unusual to see it pop up in so many different places at once the first case was identified in May of 2022 and involved someone who had traveled to Nigeria, which is not unheard of, But since then, other cases have been identified where people hadn't traveled to endemic countries and exactly where or how they became infected isn't clear yet. This suggests that there may have been either community or person-to-person transmission. Community transmission is when there isn't a clear contact point with someone who is infected and contagious and monkeypox lends itself to this since it can be spread via contaminated bedding, towels toothbrushes or other not human contacts person-to-person transmission is of course like what it sounds like contact with an infected and contagious person spreads it to another person and this has been seen with monkeypox but outside of the places where the virus is endemic person-to-person transmission has only been documented once before and this spread outside its usual range is basically the big reason this is getting so much attention many of the current cases have been in gay and bisexual men who have sex with men however that could actually be a confounding factor not a clue that's because monkeypox is not considered a sexually transmitted infection it does spread through close contact and sex certainly qualifies, so some experts have speculated that could be aiding transmission, but it's also likely that monkeypox is simply being spread in environments these people are congregating in and, due to the history of HIV and aids, they might just be a community more likely to notice infectious disease early. That is why it's important for us to learn more about how this virus is spreading so that we can be sure we're catching all of the communities affected as for how deadly this outbreak is a draft of the current outbreak's genome has already been sequenced, and it looks like it's related to the West African strain of the disease which has a fatality rate in endemic countries of about one percent and this is great news because the other option is a variant whose fatality rate is closer to 10, However that number may also not be applicable since the non-African countries it's popping up in have more medical resources at their disposal than the countries it is endemic to there haven't been any reported deaths in the U.S. or Europe yet and the good news is that vaccines and treatments do exist for smallpox. Like I said earlier, smallpox vaccines provide some protection against monkeypox. In fact, they can even be given up to four days after exposure to monkeypox in what the experts call post-exposure prophylaxis antiviral drugs developed for smallpox are also effective, of course once again This is an equity problem. Resource-rich nations like the US have stockpiles of smallpox vaccine that can be used to treat outbreaks, while in central and West Africa, monkeypox is not quite business as usual but also not new. Indeed, some African doctors have pinned their struggle to manage monkey box outbreaks on a lack of access to vaccines and treatments so to recap monkeypox is a disease we have known about for decades It's usually rare and crops up in rural rainforest regions of certain African countries, but has become more frequent over the past couple decades maybe as a result of waning smallpox immunity. Now there is an outbreak outside of the countries we would normally expect in higher numbers than we'd expect, a lot more investigation needs to be done to determine why and how it seems to be spreading more easily than it has in the past. However, treatments do exist and unlike most emerging infectious diseases we are not forced to start from scratch and of course we will update you if the situation gets worse so stay tuned, and thanks for watching if you just learned something new about monkeypox, you might not be surprised that there is a lot to learn and also correct from our previous understandings about other diseases like the Black Death like you might have thought that you knew all about the Black Death, but scientists discovered that it was so deadly and fast spreading thanks to a bacterial mutation that happened a hundred years before the plague even got to Europe Those are the kind of new insights you can learn about from one dream. 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