The fight against smallpox in the 20th century can be compared to an action-packed thriller with elements of horror and detective story. And if everything ended well in the “original film”, then the ending of the second part remains open. The fact is that during the global eradication of smallpox, in 1959, scientists were faced with another variety of this dangerous infection – monkeypox.
Patient zero is thought to be a boy from Central Africa who came into contact with sick animals. A little later, monkeypox reached the animals in the Moscow Zoo, but the outbreak was stopped thanks to vaccination. Several decades have passed since then, and few could imagine that in the 21st-century smallpox is again walking the planet. Nevertheless, in May of this year, dozens of cases of monkeypox were recorded in the United States, Europe, Australia, Canada, and Israel. Is another pandemic approaching us? Let’s figure it out.
Smallpox in the USSR
The story begins in December 1959, when 53-year-old artist Alexei Kokorekin returns to Moscow from a business trip. His creative trip to India ended a day earlier than promised, and the man went straight from the airport to his mistress. At the meeting, Kokorekin presented her with overseas gifts, among which was the carpet of the late Brahmin, whose funeral our hero attended. That same night, Kokorekhin became ill and his mistress called an ambulance.
We know about what happened next from the memoirs of graduate student Vladimir Golyakhovsky and surgeon Yuri Shapiro, who worked at the Botkin Hospital. Since Kokorekin was an important person, he was examined by the head of the Department of Infectious Diseases, Academician Rudnev. He concluded that the man had “a severe form of the flu.” Following the leading specialists of the USSR visited the patient and gave him a variety of diagnoses: from typhus to plague and skin dermatitis.
The situation cleared up when Kokorekin died
The situation cleared up on the night of December 29-30, when Kokorekin died. The diagnosis of smallpox, as Shapiro and Golyakhovsky recall, was made posthumously by an unknown pathologist from Leningrad. Two days after the diagnosis was made, the hospital was quarantined, along the way surrounding it by a police cordon. The reaction of the authorities was lightning fast – everyone who had contact with the artist was sent to quarantine. And, as the dear reader may have noticed, the late Indian Brahmin became the cause of the dramatic events.
As a result, on January 18, 1960, 75 confirmed cases of smallpox were detected in Moscow (all infected were in contact with Kokorekin). In the capital, the infection was detected in 46 people, three of whom died. Fortunately, clear and coordinated action by the Ministry of Health ended the outbreak in just 19 days, vaccinating 10 million people along the way. Brilliant work, agree.
Black pox: symptoms and treatment
The case with Alexei Kokorekin was the first in the USSR after 1936 when the disease was finally exterminated in the country. Smallpox, as it is sometimes called, is one of the most dangerous viral diseases known to mankind. Its causative agent, the variola virus, belongs to the family of orthopoxviruses (scientifically Poxviridae). The World Health Organization (WHO) estimates that smallpox has claimed millions of lives around the world.
So what did the clinical picture of smallpox look like? Reportedly, the first symptoms appeared 10-14 days after infection. In some cases, the incubation period was 17 days, during which no symptoms were observed. Smallpox was diagnosed by flu-like signs and symptoms, including fever, headache, fatigue, vomiting, back pain, and skin pustules.
A few days after the onset of the first symptoms, smallpox affected the face, hands, and forearms. Then, the disease covered the whole body with characteristic small blisters (pustules) filled with a clear liquid, which gradually turned into pus. On the eighth or ninth day of illness, the scabs fell off, leaving behind deep scars. The mucous membranes of the nose and mouth were also littered with ulcers.
Smallpox was successfully transmitted from person to person, and its direct transmission required prolonged contact with the infected. The virus was transmitted by airborne droplets through coughing, sneezing, and talking. Even the objects with which the patients came into contact posed a danger. On average, three out of every ten infected people died.
How did monkeypox start?
But back to 2022, the first half of which was held under the auspices of the COVID-19 pandemic.
On May 18, officials from the US Centers for Disease Control and Prevention confirmed monkeypox in a patient who recently returned from Canada. Cases of infection have also been reported in the UK, Canada, Australia, Israel, and several European Union countries.
To date, scientists are aware of the existence of several varieties of smallpox, which is a zoonosis: it is assumed that African rodents played an important role in the transmission of the virus. But monkeys, contrary to the name, are not the main carriers of the disease. For most of the time, monkeypox was considered a rare disease.
Note also that the monkeypox outbreak is taking place against the background of rapid climate change, which is causing millions of people to leave their homes. The situation has already led to massive climatic migrations, which, among other things, contribute to the spread of infectious diseases, including the monkeypox virus.
Monkeypox: symptoms of the disease
Most cases of monkeypox infection have occurred in the Democratic Republic of the Congo, according to health experts. The further spread of the infection can be explained by international travel and the importation of infected animals into certain countries. Since smallpox has been considered eradicated since 1972, the vaccination of the population has been stopped.
Researchers attribute today’s outbreak to the development of civilization and the expansion of trade routes. Penetrating into the human body and overcoming the incubation period, the disease manifests itself in all its glory. Signs and symptoms of monkeypox include:
- Fever
- severe weakness
- Headache
- Severe back pain
- Skin rashes
- Nausea, vomiting (rare)
- As with smallpox, monkeypox is accompanied by swollen lymph nodes. In severe cases, characteristic skin rashes are observed, first on the face and genitals, and then throughout the body. Upon recovery, the scabs fall off, and the duration of the disease is several weeks. According to WHO, most infected people recover, although the virus can be fatal.
How dangerous is monkeypox?
As the British Guardian writes, citing UK health officials, the number of identified cases could increase in the coming months as the virus spreads across Europe. Fortunately, the disease is not as severe as smallpox and is less likely to result in death.
Interestingly, most reported cases are among young gay men who have not traveled outside their own countries. WHO experts check the reliability of this information, so it is not worth drawing premature conclusions. In addition, monkeypox was not previously considered a sexually transmitted infection.
Experts estimate mortality from 1% to 10%, which is quite a lot, to say the least, and urge the public to take the outbreak as seriously as possible. The fact is that we are dealing with a completely new virus that has never been studied before. The currently circulating form of smallpox is considered mild, with a mortality rate of at least 1%. Two deaths have been reported so far, according to reports from West Africa.
Monkeypox vaccination and treatment
Since there is no cure for the smallpox virus, precautions are taken to relieve symptoms. There is good news in this story too: according to available data, the smallpox vaccine can prevent infection and reduce the severity of symptoms. Experts recommend that doctors be vaccinated first of all since they are at the forefront of the fight against the disease.
The researchers also urged not to panic, as monkeypox is unlikely to overtake COVID-19 in terms of spread and mortality. And although the virus has pandemic potential, the world community has a chance to stop the march of infection across the planet, as it did in Moscow in 1960.
As for our fictional thriller with horror and detective elements, its ending is still open. Further action by the global community can stop the spread of the disease. Otherwise, another pandemic awaits us. So let’s hope for the best. Take care of yourself and your loved ones and don’t forget – the smallpox vaccine still works great, and not a single case of this dangerous disease has been registered in Russia.
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