Monkeypox Virus in the Democratic Republic of Congo

Monkeypox virus is also referred to as a “sylvatic zoonosis virus” - a virus, which is transferrable from animal to human, however the virus originates from an animal classed as wild- the original carrier of monkeypox being crab-eating monkeys. The transmission of the virus is believed to occur through rodents- specifically Gambian Rats and “Prairie Dogs”. Controversially, bush hunting and fresh infected meat have become the main source of transmission.

The article this essay is based upon, focuses on a vaccine being approved in Canada, which even concludes that “While monkeypox is endemic to certain parts of Africa, orthopoxviral infections may occur from animals to humans all over the world”. Scientists have data which allows belief that Monkeypox virus has been around since 1970, which evolves to the main question of where is this vaccine?

In 2019 a vaccine was approved by the USA; however, it is “not yet widely available to the public sector”. As well as this a vaccine has still not been available to the areas where the virus originates from; moreover, the vaccine itself is approved for use to infected people over the age of 18. Data from research on the transmission and severity of symptoms contrasts this- e.g. Rash severity- suggests that children between the ages of 5-14 have a higher percentage of severity than those over the age of 18. 

Approximately 54% of monkeypox cases are found between the ages on 5-14, with over 60% of cases overall in the country found within primary education; children there found to be under the age of 18. Furthermore, the highest percentage of rash severity is found within the 5-14 age group, where 57% have mild/moderate rashes, and 48% carrying severe rashes. The contrast by this is that adults contribute to the overall number of cases by approximately 25%, with 23% having moderate rashes and 29% having severe rashes.

Additionally, there is a HHS Public Access manuscript introducing vaccinating against monkeypox in the DRC, which was produced in 2019, “discussing and evaluating the effectiveness, immunogenicity and safety of a third generation smallpox vaccine”. The current results of the study give no clear indication of a vaccination that is ready, “however the serologic monitoring of study participants will continue at roughly 6-month intervals until the 2-year timepoint is reached”. “Since 1970 the epidemiology and clinical features of the disease have been extensively characterized but no specific medical countermeasures have been introduced” . This therefore promotes the lack of control of the transmission- especially as no clear communal measures have been put in place to support this ongoing study.

Prevention of the virus spreading within communities of DRC, “has been found difficult due to the increase in refugee’s, cultural impacts and the overall difficulty of disease control, due to the pollution within water sources, both in poor and more financially sustained areas”. A lack of access to healthcare is a key reason as to why an uncontrollable spread is obtained. During a survey of “all health zones, more than 8/10 households had one or more-member fall ill in the six months prior”. 

The provinces report “the highest number of suspected cases of Monkeypox in Sankuru with 973 (21.2%) suspected cases and Mai-Ndombe with 964 (21%) suspected cases” (WHO, 2020); these areas surround the health zones explored within the survery. Which does support the explanation as to why the virus transmission has been poorly maintained. Arguably, the DRC is “considered one the richest countries in the world regarding natural resources, however its wealth is poorly distributed as the citizens themselves are among the poorest” in the world. Furthermore, the DRC is a major course of displaced people, while also hosting several refugees from neighbouring countries. Which evolves to the control of a virus becoming very difficult without appropriate measures.

The Monkeypox Virus vaccine is “currently stockpiled in the United States for use during an emergency”, “to protect individuals who are at risk of developing side effects from older vaccines”. A contrasting viewpoint would discuss side-effects which bypass any chance of immunization. However, data in this study provide supportive information for the use of IMVAMUNE vaccine, “protecting against human infections with monkeypox virus”. The study prevailed that only a very small percentage of the subjects used within “testing succumbed to infection” and no major side effects.

Despite the recent prevailing of a vaccine, whilst researching this topic, I have noticed limited mention of measures put in place to prevent transmission; such as isolation of an infected person, or proper medical care to decrease the severity of the symptoms. Concluding, that the overall defect of medical care, poorly maintained prevention measures and the delayed response to this virus have hugely impacted the reoccurrence of the Monkeypox outbreak in the Democratic Republic of Congo.