Monkeypox threat remains…: Experts explain 4 ways the virus may evolve in future

Earlier this year, monkeypox suddenly started spreading across the world and within a short span, more than 73,000 cases and 29 deaths have been recorded in over 100 countries. But since peaking in July, infection numbers have consistently fallen, particularly in Europe and North America. The number of new global cases fell by 20 percent in the seven days up to Sunday compared to the previous week, the WHO said.

“We are heading towards the end, but we are not there yet,” Jean-Claude Manuguerra, head of the environment and infectious risks unit at France’s Pasteur Institute, told AFP.

WHO chief Tedros Adhanom Ghebreyesus said last week that “a declining outbreak can be the most dangerous outbreak, because it can tempt us to think that the crisis is over, and to let down our guard”.

Apart from awareness campaign, Carlos Maluquer de Motes, a virologist at the UK’s Surrey University, said vaccinating against monkeypox “has helped, but the number of available doses remains low”.

However, the vaccines, which were originally developed to fight smallpox, are still recommended to protect against monkeypox.

The European Center for Disease Prevention and Control (ECDC) said this week that robust data on the effectiveness of the vaccines was “still lacking”.

A preliminary analysis by the US Centers for Disease Control and Prevention last month however found that unvaccinated people were 14 times more at risk of getting monkeypox.

What are the possible scenarios for the future?

Warning that “significant uncertainties remain”, the ECDC laid out four possible scenarios for how the outbreak could evolve.

The worst case scenario is that monkeypox has a resurgence worldwide as the behavior of at-risk groups returns to normal.

A likely scenario is that the virus stays at a relatively low level, with sporadic outbreaks “almost exclusively” among men who have sex with men, the ECDC said.

Or monkeypox could wane or even be eliminated completely.

Monkeypox is much less contagious than Covid, and does not mutate into other variants as rapidly.

However, “the more cycles of infection there are, the more likely monkeypox is to change and adapt”, Maluquer de Motes said.