Why many experts believe the disease needs a better name

In its latest update on monkey pox in mid-June, the World Health Organization said cases had been reported from 42 member states in five of its regions – the Americas, Africa, Europe, the Eastern Mediterranean and the Western Pacific. A total of 2,103 laboratory cases were reported, including one death.

The outbreak mainly affected men who had sex with men or who had reported recent sex with new or multiple partners. The World Health Organization pointed out that the unexpected appearance of monkey pox in several regions that had not previously reported cases suggested that there may have been undetected transmission for some time. It said it considers the risk at a global level to be moderate.

However, the debate that has dominated the headlines has revolved around the World Health Organization announcing that it is “working with partners and experts from around the world to change the name of the monkeypox virus, its clades and the disease it causes”.

Just before the World Health Organization statement, a group of 29 scientists advocated a non-discriminatory and non-stigmatizing nomenclature for monkeypox virus.

They called for a nomenclature or name that is neutral and more acceptable to the global health community. They proposed a naming system similar to the Pango nomenclature used by researchers and public health experts worldwide to track the transmission and spread of SARS-CoV-2, including variants of concern.

As an African scientist, I agree with this appeal. The new name for monkeypox should be aligned with best practices in naming infectious diseases to avoid the uninformed negative narrative that associates diseases with regions. There are no wild non-human primates in Europe. There are many monkeys and apes in Africa, Asia, and Central and South America. Monkeys are usually associated with the global south, especially Africa.

In addition, there is a long dark history comparing black people to apes. No disease nomenclature should give rise to this.

The history

Monkeypox is a disease caused by the monkeypox virus, a member of the same family of viruses (smallpox viruses) as smallpox. The virus was first identified in lab monkeys in the 1950s — hence the name. However, rodents, squirrels and non-human primates are believed to be the reservoir hosts.

The first case of monkey pox in humans was confirmed in 1970 in the Democratic Republic of the Congo. Since then, there have been periodic outbreaks in West and Central Africa, where it is endemic in 11 countries. We do not know the true prevalence of the disease.

Nearly all monkeypox outbreaks in Africa before 2022 resulted from animal-to-human transmission. Only rarely have there been reports of persistent human-to-human transmission. This has not been the case with the cases reported since May 2022. The cases presented in healthcare facilities were people who had traveled to countries outside Africa.

The main symptom of monkeypox is a rash that looks like chickenpox. Monkeypox can be spread through close contact with an infected person’s bodily fluids, respiratory droplets, and contaminated materials.

Monkeypox is rarely a public health emergency. The infections are usually mild, compared to smallpox or chickenpox.

Naming Conventions

The World Health Organization guidelines recommend avoiding animal names or geographic regions for viruses and diseases.

The current classification of the genetic diversity of monkeypox virus recognizes two clades of the virus referred to as the ‘West African’ clade and the ‘Central African’ or ‘Congo Basin’ clade.

Some genome sequences in the NCBI Genbank database use “West African” for the “strain” or “genotype” field. Lessons learned from objections to naming the Omicron variant of SARS-CoV-2 as the “South African variant” have informed the use of the Pango nomenclature for SARS-CoV-2.

Naming infectious diseases based on locations of first detection is misleading due to limited diagnostics or priorities in different regions. It may also delay the reporting of new variants of infections discovered in Africa.

As leadership in infectious disease research in Africa gains recognition, African scientists are also working to ensure that gains are not overshadowed by historical bias. It’s good to know that they are being listened to.

Moses John Bockarie is an adjunct professor at Njala University.

This article originally appeared on The Conversation.

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