Exploring First-World Ignorance of Monkeypox

Photo Credit: NIAID

By Drew Frank
Staff Writer

On May 18, 2022, the first case of monkeypox in nearly 20 years was recorded in the United States. Prior to this, the virus was for the most part contained within its endemic countries such as Cameroon, the Democratic Republic of Congo (DRC), Nigeria, and South Sudan, having been present in these areas since 1970. Despite the disease’s prevalence in Central and West Africa, it found itself largely ignored by Western media as a pathogen of risk as it took hold in African nations, many of whom lacked the proper health infrastructure to effectively address any sort of disease. Even with a long period of consistent infection in Africa, monkeypox was continuously ignored by the developed world. Considering its more widespread impact in 2022, looking back on why this occurred could be an important step in assessing future pandemic preparedness. To analyze the issue, the international community must take a look back at monkeypox’s history: its endemic status in African nations, its past (albeit brief) outbreak into the developed world, and how despite a clear scientific consensus that it could become a threat, it was ignored up until a large-scale outbreak.

Monkeypox first emerged in the DRC in 1970, infecting a nine-month-old child; the disease would soon spread throughout the nation and spill into others. Largely theorized at the time to stem from animal contact, it was particularly devastating in the area due to a high proportion of rural communities being in close proximity to biodiverse wilderness habitats. The smallpox vaccine has been proven to be effective in assisting in protection against monkeypox, yet most in the DRC lacked access to it due to cost concerns. The country’s weak healthcare system burdened by civil unrest meant that those who were afflicted weren’t able to receive adequate care. As such, the mortality rate in unvaccinated persons was found to be near 11 percent. Furthermore, monkeypox’s human-to-human transmission rate in the DRC was found to be about 28 percent. In the nation, not only was it a somewhat rapidly spreading pathogen, but a dangerous one as well. Up until the mid-1990s, infections were relatively limited to younger people who came into contact with infected wildlife in the rainforest. A resurgence of the pathogen in 1996 led to a higher degree of infections in the older population, as well as a much higher rate of spread from person to person rather than from an infected animal. Although the situation was monitored by the World Health Organization, little action was taken to curtail the dangerous effects of monkeypox in the DRC and in other Central and West African nations. 

On May 24, 2003, a 3-year-old girl was hospitalized in Wisconsin due to a serious infection following being bitten by a prairie dog traded at a swap meet. Originally thought to be an isolated infection, more cases would pop up around the general area over the next few weeks. Eventually, it was determined that a specific population of prairie dogs at the swap meet were infected with monkeypox, and a swift and decisive case-finding response ensued using trace-back and trace-forward techniques. Cases were traced to Wisconsin, Illinois, and Indiana, and the outbreak was seemingly contained with just over 70 total cases tracked and monitored in the United States. 18 people were hospitalized, and two even contracted severe clinical illness with encephalitis and tonsil lymphadenopathy. Health departments in the United States– and hence media outlets reporting on the issue– had mixed opinions on whether or not this outbreak was indicative of anything larger, or even if it was something worth being concerned over. But these mixed opinions rarely resulted in productive journalism on the topic, only continuing the ignorance of monkeypox in the country.

Despite the already existing scientific evidence that human-to-human transmission was possible due to the existing outbreaks in Central and West Africa, media outlets as well as the CDC in the United States largely stressed that monkeypox was almost entirely spread through animal-to-human contact. It was indeed true that this had been the primary method of transmission in the 1980s, but scientists had already observed that the human-to-human method of transmission had become more prevalent and had even eclipsed the animal-to-human transmissions in the DRC. Any virus with human-to-human transmission capability should be of concern to the international community, yet monkeypox was seemingly not treated as such. Although the containment of the small outbreak in the Midwestern United States was unequivocally a good thing for public health, it’s also worth noting that it may have had negative consequences in the long run– for the government, for public health, and even for the media’s integrity. The fact that a swift and decisive response had stopped an outbreak that had spread between states posed as a positive story for news outlets to report on. It coaxed out a false sense of reassurance that there was no way a disease that was contained so effectively could ever become a problem in the United States, despite the fact that it was still infecting and killing in West and Central Africa.

Today, as monkeypox has crossed a gap into the developed world, it’s important to take a step back and re-evaluate the methods through which coverage of the illness is being communicated. When reports on the re-emergence of monkeypox in non-endemic countries (and eventually the United States) began to come out in 2022, news outlets and the American government response as a whole failed not only in taking accountability for past actions but even in addressing the historical context of the illness. In fact, one of the early articles detailing the initial new outbreak in Massachusetts downplays monkeypox so much that it barely addresses the disease’s impact in any countries outside of Nigeria. The article goes so far as to even say that there had been “four decades without a confirmed case” in seeming reference to Nigeria, yet there’s no clear indication that they mean Nigeria alone rather than the world at large. 

Articles such as these only make brief mention (if any) of the historical implications of monkeypox, and the disease’s impact and severity in Central and West Africa– and, unfortunately, this only repeats what appears to be the case when it comes to ignoring history. Not only did the developed world fail to take steps to address and inform about monkeypox when it raged in West and Central Africa, but they neglected to acknowledge monkeypox’s historical background as well, even when it invaded their own countries. Prior knowledge is a valuable resource for the mitigation of disease outbreaks, as seen with existing research on SARS and MERS aiding in the fight against COVID. Though the modern-day monkeypox outbreak was not handled with historical contexts in mind, it does serve as a reminder that it’s imperative to research and report on pathogens thoroughly even when they don’t seem like they could spread worldwide.  

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