What are the risks

It is difficult to say at what stage the disease becomes fatal. Before the 2022 monkeypox outbreak, an inaccurate death rate of 1-10% was reported.
This large discrepancy is caused by the presence of two main strains of imboxvirus: strain 1 and the much less dangerous strain 2.
This second strain caused the outbreak of the epidemic in 2022, and the resulting mortality rate was less than 1%, which also explains the effectiveness of health care systems in developed countries.

What's new

It is strain 1 that is causing this time the outbreak of monkeypox about a year ago in the Democratic Republic of Congo, and to a lesser extent in other African countries such as Burundi and Kenya. Congo announced on Thursday the registration of 548 deaths since the beginning of the year out of about 16 thousand "possible" infections counted.
This outbreak is partly related to strain 1, but also to the emergence of a new mutation, "1B", which is suspected to be more dangerous, but this has not been proven.

The new mutation was detected this week in Sweden, in the first infection outside Africa. In Asia, the first case of monkeypox was detected in Pakistan, but the strain is unknown.

"It is not surprising, given the seriousness of the epidemic in Africa and the outbreak in it, that intercontinental flights brought this infection to Europe," Cambridge immunology professor Brian Ferguson said, probably expecting more infections in the world if no specific measures are taken.

Who is threatened with the disease

The current outbreak in Africa has been most deadly among children, which is not surprising since strain 1 "is known to cause more serious diseases in younger children, pregnant women and immunocompromised people," explains virologist Jonas albaraz.
But he pointed out that the variant "B1" is especially common among young adults, apparently transmitted through sexual contact.

And this difference raises the question of the mode of transmission of the virus for each mutant. In 2022, the virus was spread through sexual contact, and the vast majority of infected people were gay, lesbian or bisexual.
However, the virus is more widely transmitted through bodily fluids such as saliva, direct contact with the rash, which explains the infection of children.

What now? (chuckles)

It is not known to what extent the virus will spread outside of Africa. The injured in Sweden came from the African continent. Professor Francois Ballou, of the University College of London, said: "there is currently no evidence of an infection in Europe.

The European Center for Disease Prevention and control considers this risk to be low. But the agency said on Friday that it was "very likely" that European countries would face an increase in imported strain 1 infections, and recommended that health authorities be ready "to allow rapid monitoring and response to any new case".

If the health authorities are currently anxiously monitoring the spread of the virus, led by the World Health Organization, which has issued a high-level alert, it is because of its serious consequences in Africa.

Vaccination is essential in this regard. There are several highly effective vaccines against monkeypox, but they are not available in Africa, while when the virus spread in 2022, developed countries easily launched vaccination campaigns. Immunology professor Brian Ferguson said it was "possible" to combat the virus outbreak, but " this requires rapid international cooperation."