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MONTREAL – A Canadian plays an important role in the World Health Organization’s fight against monkeypox.
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Dr. Rosamund Lewis, technical leader of efforts to combat the global outbreak of the virus in the WHO Emergency Health Program, grew up in Thunder Bay, Ont. and Ottawa.
After graduating from McGill University School of Medicine, Lewis practiced in Montreal before joining the WHO. The organization is currently working to suppress the spread of monkeypox, which comes from the same family of viruses as smallpox.
Canadian Press reached Lewis in Geneva, Switzerland, for an interview.
What do we know about the spread of this disease?
We think it is spread by rodents, but we do not know what kind it lives naturally. In Africa, we find the virus in the Congolese squirrel, the Gambian rat, the dormant and the like. People hunt in the woods and bring back meat that they have to cook. This is the traditional type of exposure (to the virus). It is also possible for the family to eat insufficiently processed meat. This meat can also be sold on the market, so even people who do not have direct exposure to the forest can be exposed.
But another major factor is that smallpox was eradicated in 1980, so people born after 1980 or in certain countries after 1960 or 1970 were not able to be vaccinated against smallpox.
Has monkeypox been seen in the west before?
There were two cases in the United Kingdom in 2021 and two in the United States, also in 2021. There was an outbreak in the United States in 2003, but it had nothing to do with the current situation. It was very strange. It involved prairie dogs that were sold as pets, and children began to get sick after being scratched or bitten. It took about three months to understand the nature of the outbreak and to control it.
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How did the current epidemic start?
Once again, we have received reports from the United Kingdom. It was a traveler who came back from Nigeria and found he had monkeypox, and I said to myself, “Okay, it’s started.” The United Kingdom found a hearth in a family, and this was completely unexpected because it involved three members of the same family. This was the first time we had seen monkeypox outside of Africa with someone who hadn’t traveled recently, so it was new. (The British) then found it in samples from their laboratories, which were positive and came from men who had sex with other men.
At the same time, Portugal reported an outbreak of people with undiagnosed lesions. They were negative for herpes, negative for syphilis, so the Portuguese were looking for information, and relatively quickly Portugal and the United Kingdom realized they were facing the same thing.
Men who have sex with men have participated in certain events and then returned home.
The first cases are related to travel from Central Europe. This is where we are now, except that we see many cases and it is spreading in this group of people who have frequent physical contact with more than one person, probably for a very short period of time, so the conditions are right for rapid transmission and dissemination.
So there is an opportunity for action that should not be missed?
Yes, and it is extremely important to take advantage (of this time) before the virus affects the general population, family members, children, vulnerable people, such as people who are HIV-positive. But we cannot be anxious. The majority of cases are still reported in this group, so transmission occurs there, it is not too late to stop the outbreak in this group, although it may be difficult. However, there are still many things we don’t know about the virus, and we have to be honest and admit it. The virus itself may have undergone changes that make it more transmissible, but we have certainly seen behavior that makes it more transmissible. This disease manifests itself as an infectious disease that is spread through close contact, including sexual contact. So the message to the public is this: educate yourself, learn to recognize the signs and symptoms, know the circumstances in which you could become infected, protect yourself and protect others, and when in doubt, seek a diagnosis.
This interview, which took place on June 6, 2022, was edited and shortened for length and clarity.
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