Dhe world map of the current outbreak of monkeypox is clear compared to that of Covid-19 – with more than half a billion people infected and almost six and a half million fatalities. The American Centers for Disease Control and Prevention, CDC, documents online how monkeypox spreads. The list of affected countries can be accessed there alphabetically or by number of cases: Andorra, for example, has only reported three cases, while the United States has registered more than 7000 infected people since the beginning of the year as of Friday, August 5, 2022, followed by Spain (4577), which also has the first two deaths in Europe, Germany (2839), Great Britain (2759), France (2339), Brazil (1474), ahead of the Netherlands and Canada. This makes it clear that the infection process, with around 27,000 cases, is currently taking place mainly in countries where monkeypox is not endemic, such as in West and Central Africa – but could well become so.
The fact that the pathogen finds a reservoir in wild animals in Europe or North America is one of the major concerns of this epidemic, which the World Health Organization on July 23 declared a “health emergency of international concern”. Another is that the pathogen is increasingly spreading to parts of the population who do not belong to the ad hoc risk group of homosexual men but are at risk of becoming seriously ill. What is to be feared about the case of a ten-year-old boy who presented to an Amsterdam emergency room at the end of June, was diagnosed with monkeypox, treated accordingly and observed. How or where he got infected is a mystery. However, this child was found to have a mild immune deficiency, resulting in a lack of IgA antibodies, which in turn makes the affected airways more susceptible to germs. And this connection could have played a role in transmission through droplets, for example, his doctors speculate in the case study published on the subject.