Shortcuts / 28 July 2022

Monkeypox and foot and mouth disease

If you’re feeling more virus literate these days, you’ll be right onto 2 more that are going around – monkeypox and foot and mouth disease (FMD). To give you the backstory to them, this Squiz Shortcut will cover off what monkeypox is and what led to it being declared a global health emergency, what FMD is and the threat it poses to our farming industry, and the steps that are being taken to combat both viruses.

First off, what is monkeypox?
It’s from the same family as smallpox, but it’s much less severe. Both smallpox and monkeypox are from the Orthopoxvirus genus. In total, there are 12 types, including camelpox, cowpox, and horsepox.

And chickenpox?
Actually, no… Chickenpox is from a completely different genus.

There you go… So did monkeypox start with monkeys? 
Yep, and that’s the thing with an Orthopoxvirus – it can be transmitted by respiratory droplets, contact, and zoonosis – which means that it can be passed from animal to human.

Gotcha. Wasn’t smallpox a pretty horrendous disease back in the day?
It sure was. Smallpox is now eradicated and no naturally occurring cases have happened since 1977. But before that, about 3 out of every 10 people with the disease died, and it also left many people blind. In the last 100 years before it was extinguished, smallpox killed more than 500 million people. 

How was it eradicated?
It happened thanks to vaccination, and it was quite a triumph. Not only was the vaccine the first to be developed against a contagious disease, but smallpox is also the only human disease to have been eradicated.

So what’s the deal with monkeypox?
Most cases of the virus are mild, sometimes resembling chickenpox and usually clearing up on its own within a few weeks. Transmission of the disease usually requires direct skin-to-skin or prolonged face-to-face contact with an infected person.

What are the symptoms?
They can include fever and then a rash that usually begins on the face before spreading to the palms of the hands and soles of the feet. It’s said to be extremely itchy and painful, and then it forms a scab, which later falls off. Those lesions can cause scarring.

Ouch… Are there different strains of monkeypox?
Yep, west African and central African. The west African strain has a 1% fatality rate, which is similar to COVID – and the central African strain has about a 10% fatality rate. It’s the milder one that’s currently circulating around the world.

But it’s still a cause for concern?
It sure is – this week, the World Health Organization declared the monkeypox outbreak to be a global health emergency, with more than 16,000 cases now reported in 75 countries.

Is it a global issue?
Yes, but the WHO says monkeypox poses a moderate risk globally – except in Europe, where the risk is high.

That doesn’t seem too bad…
No, but the increase in case numbers and geographical spread concern officials. In the countries where it’s been considered endemic for many years, there have been 1,200 cases reported this year.

What happens now that declaration has been made?
First, it will speed up the development of a vaccine. It’s unlikely that a specific monkeypox vaccine will be developed as quickly as we saw with COVID, but it will be bumped up the to-do list. And the 2nd reason is there will be support for measures to limit the spread of the virus.

Is there a vaccine now?
Not specific to monkeypox. Patients can be offered a vaccine designed to protect against smallpox called Imvanex. And there are anti-viral drugs that can help. 

Who is most at risk of developing monkeypox?
The WHO has called out gay and bisexual men – particularly those with multiple sexual partners. That’s because 98% of cases have so far occurred in men from those groups, with 95% of cases emerging from sexual activity.

What’s happening with cases in Oz?
So far, 44 cases have been reported across all states and territories except Western Oz and Tassie. Most of those were contracted overseas. 

Are authorities confident they can get the outbreak under control?
They are – authorities reckon it can be controlled, and isolating people with the disease is important, they say.

Rightio. Tell me about foot and mouth disease…
Let’s call it FMD, shall we? It’s an infectious and sometimes fatal viral disease that affects cloven-hoofed animals, including cows, sheep, pigs and goats.

Does it have anything to do with the gross thing kids get?
That’s hand, foot and mouth disease. It’s different, but both diseases involve a period of high temperatures followed by blisters – for animals with FMD that’s in their mouths and on the feet.

How else does FMD affect animals?
It can also cause weight loss, dry up milk in dairy cows and affect breeding cycles. And species other than pigs can be asymptomatic and still carry and spread the virus.

That’s not good…
Not at all, and the kicker is that it’s heaps contagious.

Why is FMD being talked about now?
There’s a lot of concern about the recent outbreak of FMD in Indonesia. It resurfaced there in May after being free of it for over 30 years, and it has since spread to Bali.

And that’s an issue because…
Bali is a popular destination for Aussie tourists. The concern is less that travellers will contract FMD because human infections are rare. It’s that they might bring the virus back with them on their clothes or shoes or via meat or dairy products. 

So if it arrived here, what would it mean?
A single reported case would force the culling of thousands of animals – even if they aren’t showing signs of infection.

Really? Why?
Because it’s so very contagious and drastic moves would be made to stamp it out. 

How does it spread?
FMD most commonly spreads during the movement of animals, and because the virus can linger on objects like farming equipment, vehicles, clothing, and feed, infected properties would have to be quarantined. There’s also care that would need to be taken to burn or bury animal carcasses.

So there’s a lot at stake?
There sure is. Agricultural research experts ABARES says an FMD outbreak would cost the industry $80 billion over 10 years. But there’s more to it than the economics – entire breeding lines could be wiped out, and there would be a significant mental health toll for our farmers if they had to destroy all their animals.

I can’t imagine. 
It would be the worst. 

Have we ever had an FMD outbreak in Oz?
We had minor ones in the 1800s, but those were contained because the movement of animals wasn’t as much of a thing as it is these days.

Has FMD been a problem in other places?
There was a major outbreak in the UK in 2001, and there have also been outbreaks in the Middle East, Africa, Asia and South America – and Australia successfully managed those risks.

What’s been done so far to address those concerns?
A host of new biosecurity and surveillance measures have recently been announced, including citric acid foot mats greet travellers at airports. As of this week, every traveller returning from Indonesia will be compelled to use those mats.

Anything else?
Travellers returning from Indonesia are being asked to be really honest about whether they have been in rural areas, markets and zoos or anywhere near those cloven-hoofed animals within the last 30 days. And the National Farmers’ Federation has called on travellers to ditch their footwear altogether before returning.

Is that enough to mitigate the risk?
The government says yes, but some in the Coalition say it isn’t. That includes leader Peter Dutton who has urged the Albanese Government to consider closing the border to Indonesia. 

Will that happen?
Well, it’s something neither the farming industry nor the government believes is necessary at this stage. Government officials say the risk of FMD entering the country is less than 12%.

That’s not high, but it’s not nothing…
That’s why some farmers are preparing genetic banks to repopulate their farms using IVF in case they have to destroy whole herds. It’s all about protecting the bloodlines many farmers have spent generations developing on their farms.

Let’s hope it doesn’t get to that stage…
Indeed, so cross everything and hope it doesn’t arrive here. And declare everything if you’re a traveller.

Squiz recommends:

‘The agony of an early case of monkeypox’The New Yorker

‘Foot-and-mouth disease is on Australia’s doorstep. What will it look like if it spreads?’ABC News

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