It is now clear that the pandemics, which have progressively entered the limelight of history, constitute a health event closely connected to the globalization of which they have now become a structural element. The planetary extension of the market not only circulates goods and capital, but inevitably also humans and animals, carriers of respective endemic infectious outbreaks, i.e. originally limited to certain geographical areas, each of which with specific environment-related risk factors, as happens always for the healthindifferently threatened by chronic or acute diseases.
Sudden mass meetings could only pool, and therefore multiply, risks and mutual fragility between populations; and so it was. A price never taken into account, like the consumption of the planet, that globalization has entailed. So now all you cry is crocodile tears. That said, let’s come to the last disturbing guest: the so-called monkeypox.
In truth, the monkeys have very little to do with it, being an occasional laboratory find, because the natural reservoir of this virus, while maintaining the same name in the English language used in science (Mpx as an abbreviation of Monkeypox), consists of rodents that directly or indirectly can infect other animals, including man, making yet another leap of species. In central Africa, where MPX is endemic, human-to-human contagion is rare, while it is frequent between animals and humans, mainly children who are more sensitive and more exposed to external risk.
Based on WHO data, from the few hundred cases a year in the world, in 2022 they were reached in a few months (August) over 35 thousand cases distributed in 92 countries, mostly located in Europe (about 20 thousand) and in the USA (about 12 thousand). More than 500 in Italy, distributed fairly evenly with respect to population density for now. However, the numbers are growing rapidly. The lethality of MPX, that is the ratio between deceased and sick, is instead relatively low, ranging between 1-10% in endemic countries. A dozen deaths have been registered in the most recent months. As always, fragile subjects from a health point of view are particularly at risk. A great leap therefore which, however, mostly concerns young adults of male sex they have had homosexual relationships. It is therefore a pandemic still confined to a certain subgroup of the population, but potentially able to expand at a general level due to the uncontrolled propagation of infected waste (medicines) not adequately treated that could reach urban rodents (mice), thus amplifying the food chain. infection. In reality, contagion is difficult from man to man, because it implies close relationships between infected biological material, not only genital but also digestive and inhalation, with skin and mucous membranes, especially in the presence of small wounds or lacerations. This explains why the greatest risk is among men who have sex with other men, certainly being the homosexual relationship between males much more impactful for the integrity of the mucous membranes.
These are the evidences that led WHO director general Tedros Ghebreyesus to declare monkeypox (Mpx) during the press conference on 23 July 2022. Public Health Emergency of International Concern – Pheicor rather “an extraordinary event that can pose a health threat for other Member States through the spread of the disease and potentially requiring an internationally coordinated response ”.
In addition to the extent of the infections, the greatest risk, however, is that of creating yet another stigma that, beyond the discriminatory aspects of a neo-racist nature, would do nothing but favor the spread of the disease through the self-concealment of one’s own state of health which in turn would trigger a perverse mechanism hunting the greaser. At issue is not and should not be people’s sexual orientation, but behaviors aimed at promiscuity of partners in the absence of adequate protection.
Prevention must therefore move on multiple tracks. First of all, a communication careful not to create stigma, information able to calibrate the different levels of risk, the construction of dedicated health care paths able to absolutely guarantee the privacy of the patients, as well as the monitoring serology of urban mice in order to evaluate the possible expansion of a dangerous infectious reservoir. In parallel, one should be organized vaccination campaign addressed to the subjects most at risk, remembering however that the vaccination against smallpox, interrupted in 1981 for the evaluation of eradication of the disease, also shows a wide protection against Mpx.
The European Medicines Agency (EMA) has authorized both the use of a vaccine against the Mpx virus that guarantees a good level of efficacy and safety, and of a specific antiviral drug. Naturally, a vaccination, even if aimed at a limited target population, must be organized and supervised. However, the important thing is not to wait too long to avoid intervening in conditions of emergency with all the unfortunate consequences that we are well aware of.
We thought, or rather we hoped, that the Covid-19 pandemic had taught us a masterful lesson, that is, that the interconnection not only digital but also material would impose the identification of quick and shared solutions on a large scale. But no, we continue to proceed in a scattered and contradictory order until the water reaches the gorge. And, as if that weren’t enough, we also get into wars.
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