clinical practice
I think the best theory is that there has been , after the pandemic , an explosion in air travel in terms of interaction . This won ’ t last , but the current caseloads seem to be exclusively in men who have sex with men . So I think part of this is a behavioural issue around sexual practices , and part of it is a leftover from the pandemic in terms of we ’ re now seeing an explosion of travel .
The virus spreads via close physical contact with respiratory secretions or direct skin contact . That ’ s not new . That hasn ’ t changed in terms of people having close sexual contact . That just tells you how the virus transmits . It doesn ’ t explain why we have this current explosion in cases .
Another explanation people have looked at is , well , maybe we had it before and we just didn ’ t notice it . It ’ s not really a virus you ’ d miss because it has such overt signs of infection with the pustules , so I don ’ t think that ’ s really a reasonable explanation either .
A nurse prepares an injection of monkeypox vaccine at a clinic in France . Photo : Alain Jocard / AFP
Monkeypox explained
What ’ s in store as another virus threat arises .
Nigel McMillan interviewed by Elise Hartevelt
An infectious disease expert says not only will monkeypox cases continue to rise , but we ’ re also likely facing the appearance of new contagious diseases in the future .
According to Griffith University Professor Nigel McMillan , climate change , population increase and urbanisation have gradually been pushing the limits of protection from dangerous viruses and infections .
“ We ’ re entering into these ecosystems and viruses then have an opportunity to spread to new hosts , including humans ,” he says .
“ Among Covid , we ’ ve already seen it with other diseases such as Ebola and Japanese encephalitis in Australia .”
McMillan joined Nursing Review to speak about monkeypox and how society has been at war with infectious diseases “ since we came out of the oceans ”.
NR : Could you explain why we ’ re seeing a rise in monkeypox cases across the world now ? NM : I think this is one of the curiosities about this particular outbreak . Monkeypox has been endemic in western and central Africa for a long time . It ’ s not clear why we ’ re seeing an outbreak now . The virus itself doesn ’ t seem to have changed in terms of looking at sequence .
One of the hypotheses is that urbanisation and deforestation is impacting the spread of the disease . Could you explain how this influences the spread ? That is a very broad explanation for the rise in many , many viral infections , including COVID . There are probably three factors at present as to why we ’ re seeing an increase in a lot of communicable diseases – not just monkeypox , but COVID as well – and that ’ s population increase .
The second is global climate change , which is seeing ecosystems disrupted ; for example things like mosquitoes moving into new areas because it ’ s warmer . We only need to look at Japanese encephalitis cases in Australia , where we had a handful in 20 years , and then suddenly , we have a number of cases from South Australia and Victoria , right up to Queensland . This climate change is certainly responsible for changes in patterns there .
Then , of course , another factor is deforestation . You only have to look at Borneo since 1980 , where we ’ ve cleared a massive amount of that forest . We ’ re entering into ecosystems where boatloads of viruses live .
You could talk to HIV as one of the early indicators of that sort of
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