Dinesh C. Sharma
The world is yet to fully recover from the Kovid epidemic that even today new Kovid cases are being reported in some countries including India. Amid efforts to end this epidemic, a new health threat has emerged: the spread of monkeypox in many countries. About 17,000 cases have been reported in a total of 75 countries. So far 4 cases have been confirmed in India.
However, the monkeypox virus is not the same as the novel SARS-CoV-2 that created the Kovid-19 pandemic. However, it has spread rapidly even in countries where it had never existed before. It has had to be declared an international health emergency by the experts of the World Health Organization seeing the possibility of spreading it internationally. The disease is currently in its early stages and data is still being built on new modes of transmission. Surveillance and public health measures are suggested based on available data and previous knowledge. However, along the lines of Kovid, the possibility of this disease becoming an obstacle in travel, etc. is currently a minor, his vaccine is already underway. So no need to panic.
However, the frequency with which this disease is emerging as a health threat indicates a return to chronic and resurgent infections, especially zoonotic ones, which now dominate the global landscape. Monkey pox is a return to chronic disease. About 50 years ago it spread as a local epidemic in about 12 countries in Central and West Africa. Part of that concern is being created now because the current spread has reached some countries where it was never there before.
The properties of the monkeypox virus are similar to those of smallpox. Its recent history has been of association with the smallpox virus. The monkeypox virus was first detected in 1959 when Macanese long-tailed monkeys were used for new drug tests in the laboratory. This is from the lab in Copenhagen, which imported monkeys from Singapore. At the time the World Health Organization launched the smallpox eradication program, the medical officer in charge DA Henderson conducted a survey to see if there was a source of the smallpox virus in similar apes to humans This study was important because if the smallpox virus were to spread in the wild through apes, etc., it could threaten the smallpox eradication program.
In the 1960s and 70s, monkeys were exported from India for laboratory testing in the West. Henderson conducted the study in 26 major laboratories that housed large numbers of monkeys kept for testing. The presence of the monkeypox virus was found in many, but not in humans. The Lederle laboratory worked on about 8,000 monkeys and found the presence of the monkeypox virus in some of the rhesus monkeys that had migrated from India. A US-based pharmaceutical company Wyeth Laboratory also found that monkeys purchased from India have the monkeypox virus.
Henderson’s study, published in 1968, is an important indicator of the presence of monkeypox in Indian monkeys. The conclusion of this study was “Perhaps humans have more immunity to monkeypox virus than monkeys.” But this result turned out to be false, as the first case of smallpox in humans was found in the 1970s in Congo, Africa, when members of the World Health Organization were there in connection with an eradication program of smallpox Monkey meat is a typical dish among the local people of this area. The first case outside countries affected by this disease was reported in the USA in 2003.
In reality, animals are a storehouse of different types of pathogens and viruses. Sometimes this virus makes inroads into other species and also makes its home in humans. Over the years, we have seen the spread of various zoonotic diseases such as avian influenza, SARS, pandemic influenza H1N1, MERS-CoV, Ebola, and SARS-CoV-2 to humans. Even rabies, usually transmitted to humans by dog bites, is a zoonotic disease. The confusion between humans, animals and the environment means that viruses take the form of diseases and can even infiltrate food. One of the main reasons for the growing closeness between humans and animals is the domestication of wildlife, in addition to deforestation and the increase of carnivores. In recent years, there has been a growing interest among Indians to keep rare animals and birds found in the forests as pets at home. In many places, monkeys and dogs live in close proximity to humans and their livestock. Travel, changing food preferences and increased international trade in animals and meat have increased the risk of new carriers of infections.
Preventing and limiting zoonotic diseases requires a shared approach to human and animal infectious diseases, which is called ‘integrated health’. This means working together in a coordinated manner on different issues related to animal and human health, food, wildlife, etc. There is a need for continuous monitoring of infectious viruses that grow in humans, livestock and wildlife. Over the years, various committees, schemes and intersectoral mechanisms have been created for the implementation of ‘Integrated Health’.
The National Center for Disease Control has issued instructions to all states and union territories to form zoonotic committees at the state and district levels, but not all states have adequate mechanisms for this. Where there are panels, there is a lack of aligned coordination between the Departments of Livestock, Forests and Wildlife in terms of monitoring and follow-up. There is also a lack of technical capacity at various levels. The possibility of the influx of cross-border pathogens in the northeastern border areas needs to be monitored. In addition, the “integrated disease” surveillance program designed for new human vector viruses should be further strengthened.
Due to the large human population and its livestock living close to forest and wildlife areas, India is an important potential entry point for zoonotic diseases. The COVID pandemic and now the monkeypox outbreak are warnings of the ever-increasing threat to human and animal health, which require the necessary technical manpower and policy operation to bring reality of “integrated health” on earth.
The author is a columnist on science-related topics.