Australia: Community transmission reported in two states as monkeypox infections rise
The first locally acquired case of monkeypox in New South Wales (NSW) was reported by state health authorities on Sunday, bringing the total number of recorded infections in Australia’s most populous state to 42.
Community transmission is already widespread in Victoria, with half of the 40 infections recorded up to August 19 having been acquired in the state.
The outbreak is growing in conditions where Australians are dying of COVID-19 at a higher rate than ever before. In July, 1,949 deaths from COVID-19 were reported, making it the deadliest month on record. Another 1,638 people have died this month, at a rate of more than 70 a day.
The first two cases of monkeypox in Australia were reported on May 20. As of June 27, 13 infections had been discovered and by August 5 the total had reached 57. Over the next 13 days, another 32 cases were reported, bringing the total to 89 on August 19.
These figures represent a fraction of the true spread of the virus, in part because its long incubation period of up to three weeks means testing is a long way behind infection.
While the total number of reported cases in Australia remains low globally, the emergence of local transmission and the rapid increase in the rate of infection are of great concern.
Infectious disease specialist Sanjaya Senanayake told the Australian Broadcasting Corporation (ABC): “[N]Now there is local transmission and we are seeing what is happening in Europe and the Americas as well. I think we have to be very worried about that… As we’ve seen with COVID, if you allow enough people to get infected where the virus is replicating, who knows what it might do?
As is the case around the world, Australian health officials have downplayed the global outbreak of monkeypox and promoted the misconception that the virus can only be transmitted through male-to-male sexual contact. NSW Health’s online monkeypox factsheet recklessly states: “Most people are not at risk of monkeypox.”
Appearing on ABC TV on Monday, Heath Paynter, deputy chief executive of the Australian Federation of AIDS Service Organizations, blithely proclaimed: “Only gay and bisexual men need worry about this, the general population is not not at risk”.
These are dangerous lies. While prolonged close contact (such as during sex) appears to be the primary means of transmission, monkeypox is not a sexually transmitted disease, and certainly not a disease confined to men. Infection can be spread through aerosols, respiratory droplets and fomites – contaminated fabrics, bedding and other surfaces.
Globally, more than 43,000 infections have been detected in 95 countries and at least 12 people have died outside Africa. While the vast majority of cases worldwide have been detected in men who have sex with men, this is only an accidental product of the community in which the outbreak first emerged.
The failure of health authorities around the world to contain the outbreak is already driving infections outside of this demographic. According to the World Health Organization (WHO), at least 362 women and 35 children under the age of five have been diagnosed with monkeypox in the global outbreak. More than 250 infections have been recorded among health workers.
The most common symptoms are fever, body aches, fatigue, swollen lymph nodes and pimple-like skin lesions, which take two to three weeks to heal. While Australian health authorities insist “the disease is usually mild”, ulcerative lesions can cause severe pain.
A 50-year-old man from Melbourne who contracted the virus told the Age: “Imagine the absolute height of the pain of the ulcers in your mouth and multiply it by 20.”
The virus can also lead to complications including eye infection, blindness, skin infection, sepsis, encephalitis, rectal abscess and pneumonia. These occur most often in children and immunocompromised people.
In West Africa, monkeypox has a case fatality rate of 3.6%. Deaths on this scale are preventable and serious infections can be treated, with easy access to antiviral drugs and high-quality medical care. However, with Australia’s healthcare system already on its knees due to the ongoing COVID-19 pandemic and decades of funding cuts, the impact of monkeypox has the potential to be devastating.
Because mass vaccination against smallpox, to which monkeypox is closely related, has never been practiced in Australia, there is almost no immunity even among the older sections of the population.
In an article published last month in the Australian medical journalProfessors Raina MacIntyre and Andrew Grulich, of the Kirby Institute, warned: “Stigmatization of people with monkeypox and people who may be perceived to be at high risk should be avoided, as this can lead to decreased testing and reduced engagement with health advice.
Yet this is precisely the path that the Australian health authorities are following. Public health advisories about monkeypox are peppered with references to “multiple sexual partners” and “on-site sex venues.”
Adding to the confusion, the NSW Health fact sheet warns: “People who have recovered from monkeypox should use condoms when engaging in sexual activity for 8 weeks after recovery”, although , as explained by the agency’s executive director of health protection, Dr. Richard Broome. , “condoms are not effective in preventing the transmission of monkeypox.”
The public health response to the monkeypox epidemic has been left almost entirely to sexual health and HIV clinics. It is undoubtedly important that men who have sex with men – the demographics that are currently those most affected – can access medical care without prejudice.
However, as the virus inevitably spreads through society, the absence of any broader and coordinated response means that infections will go undetected until they are at an advanced stage and people do not get the medical treatment they need. This will be a particular danger as monkeypox begins, if it has not already begun, to spread through schools, which have also been key vectors of the coronavirus pandemic.
A third-generation smallpox and monkeypox vaccine, marketed as Jynneos, has been available since 2013 and is considered to be around 85% effective in preventing infection after two doses. However, only one company, Bavarian Nordic, produces the vaccine and global stocks are insufficient.
Only 22,000 doses have arrived in Australia, with just another 78,000 expected before the end of the year. NSW has received just 5,500 doses, while Victoria has 3,500 and Queensland a pitiful 300. In total, only 450,000 doses have been ordered.
The president of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM), Dr Nick Medland, told the Saturday newspaper“The message can’t be ‘get vaccinated’ if we don’t have enough vaccines yet.”
Post-exposure vaccination can be effective if given within four days of exposure, well before symptoms appear, meaning accurate contact tracing is essential. The current misinformation campaign about risk factors and vectors of transmission will mean that people who have been exposed will not be identified and will not receive the vaccine, even if it becomes more widely available.
As continues to be the case with COVID-19, “vaccine nationalism” and the subordination of medical science to corporate profit have played a disgusting role in allowing this global epidemic to grow. Since 2013, the United States has allowed more than 28 million doses of the Jynneos vaccine to expire in its “strategic national stockpile”, rather than using them to stop growing epidemics in parts of Africa where smallpox is monkey is endemic.
Between early 2022 and August 10, 2,947 cases of monkeypox and 104 deaths have been reported in Africa, including two countries where the virus is not endemic. Since the start of the COVID-19 pandemic, nearly 13,500 monkeypox infections and at least 394 deaths have been reported, as “the epidemic in Africa has continued to expand from country to country with little international attention,” according to the Africa Centers for Disease Control and Control. Prevention reported.
In Australia and around the world, the response of capitalist governments to monkeypox has been to replicate all aspects of the deadly pandemic policies responsible for 6.5 million deaths worldwide, according to official figures, and a actual balance probably over 20 million. In Australia, the open adoption of the “let it rip” COVID policy last December resulted in more than 11,000 deaths and nearly ten million infections.
As the response to monkeypox demonstrates, this criminal policy, enforced by the entire political establishment, has dealt a blow to decades of public health practices and standards. He laid out a plan for similar responses to all future infectious disease outbreaks, aimed at blocking necessary public health measures in the interests of government fiscal austerity and ensuring for-profit operations continue.
The alternative for the working class is to fight for a science-based approach to monkeypox and COVID-19, in which all necessary resources are devoted to protecting human health and life worldwide. This is inseparable from the struggle for socialism and for global production to be reorganized under the democratic control of workers to serve human needs rather than corporate profits.