Another pandemic?

Monkeypox spreads to 14 Latin American countries, what’s next?

Monkeypox has now been detected in 14 countries in Latin America which according to the Pan-American Health Organisation, accounts for 14 percent of global cases. Brazil, Peru, and Mexico are all registering an acceleration in the rate of transmission. Most countries in the region have already set up epidemiological surveillance programmes but regional cooperation mechanisms to combat the spread of the disease have not been established yet. 

A senior official at the Brazilian Society of Infectious Diseases said, “The Pan-American Health Organisation is trying to step in with recommendations, best practices and a willingness to assist its member countries, but it does not have a valid interlocutor in the [Brazilian] Ministry of Health and any effort of collaboration is left to die at a Federal level.” This view was shared by a Peruvian epidemiologist, “There is no regional collaboration. Some countries will plan for it better than others but just look at the impact of COVID-19, Peru was the worst hit country and Argentina and Brazil were 7th and 8th. The region is not prepared for any sort of pandemic and when they hit, they hit hard.” 

“The [PAHO] is trying to step in with recommendations, best practices, and a willingness to assist its member countries, but it does not have a valid interlocutor in the [Brazilian] Ministry of Health.” 

Senior official, Brazilian Society of Infectious Diseases 

Notably, the World Health Organisation declared monkeypox a public health emergency of international concern on 23 July. Europe is currently the region with the vast majority of reported cases, followed by the US. Although the number of cases in Latin America are still far behind these regions, the lack of information and difficulties to understand its pattern of spread can pave the way for its expansion. 

In addition to the lack of information, which causes patients to mistake early symptoms, Latin America faces an additional sociological challenge derived from the approaching of spring and summer. The increase of close, personal and skin-to-skin contact, in the context of an increase in social life in the current post-pandemic circumstances, is a reason for concern in the region. 

A Brazilian epidemiologist warned, “Brazil is as vulnerable to Monkeypox as any other country in Latin America. The next few months will be decisive to see if the region experiences a surge in cases like Europe and the US or if it learns from their experience to contain its spread. As a comparator, Canada is already vaccinating people.” 

“The next few months will be decisive to see if the region experiences a surge in cases like Europe and the US or if it learns from their experience to contain its spread. As a comparator, Canada is already vaccinating people.” 

Epidemiologist, Brazil 

Epidemiological surveillance programmes are the first step to combat the spread of the disease. Brazil still considers the surge in cases as an outbreak, the step before an epidemic and at this time the Ministry of Health has stated that it does not plan to launch a large-scale immunisation campaign. To make matters worse, the most efficient drugs against monkeypox: cidofovir and tecovirimat, are not widely available in the continent.  

Governments are now left to encourage people with fever and skin lesions to isolate until recovery, a difficult task after the COVID-19 lockdowns. This can increase stigma considering the administrations’ difficulties to reach out to specific communities such as homosexual men, who account for more than 95% of infections in Latin America. The Peruvian epidemiologist was particularly concerned by this, “There is still a stigma around homosexuals in Peru and this is just going to make it worse, we need to make sure people are not misinformed.” 

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