Monkeypox: Where Are The African Cases?
Why Are Ongoing African Outbreaks Being Ignored?
What’s wrong with this picture?
As of June 2, the World Health Organization has recorded 780 laboratory confirmed cases of monkeypox outside of the region in West and Central Africa where the virus is known to be endemic. Absent from the majority of these cases: clear links to West or Central Africa.
While the West African clade of the virus has been identified from samples of cases so far, most confirmed cases with travel history reported travel to countries in Europe and North America, rather than West or Central Africa where the monkeypox virus is endemic. The confirmation of monkeypox in persons who have not travelled to an endemic area is atypical, and even one case of monkeypox in a non-endemic country is considered an outbreak. While most cases are not associated with travel from endemic areas, Member States are also reporting small numbers of cases in travelers from Nigeria, as has been observed before.
How does a virus spread through regions where it is not endemic? How does it even get to those regions?
The WHO does not give us the answer to those questions. Indeed, one might almost conclude there are no current monkeypox cases in Africa, based on the comments from the WHO and throughout the corporate media on the topic.
Monkeypox Is Alive And Well And Spreading In West Africa
Yet if one looks towards the bottom of the WHO’s latest Disease Outbreak News bulletin regarding monkeypox, one quickly sees that an active monkeypox outbreak is very much ongoing in Western Africa.
Moreover, a review of the WHO’s DON bulletin from May 21 reveals that monkeypox is continuing to spread in West Africa.
Which makes a particular sentence from the June 1 DON bulletin striking:
While most cases are not associated with travel from endemic areas, Member States are also reporting small numbers of cases in travelers from Nigeria, as has been observed before.
To summarize the situation, we have the following key points:
1,408 suspected of confirmed cases in West and Central Africa.
780 laboratory confirmed cases outside of West and Central Africa.
Some of the cases outside of West and Central Africa have been sequenced and appear to match the West African Clade.
Some of the cases outside West and Central Africa have been reported among recent travelers to Nigeria.
Most cases outside West and Central Africa have no known travel links to Africa.
Has The Endemic Region For Monkeypox Expanded?
The current distribution of monkeypox cases outside of the known endemic region in Africa raises the question of whether monkeypox is now endemic in Europe. Certainly the vast majority of cases appear in the UK, Spain, or Portugal.
Australia’s third case is a man who recently traveled to Europe, not Africa.
A recently returned traveller from Europe has been identified as a third case of monkeypox in NSW.
A Chicago man returning from Europe is quite likely Illinois’ first case of monkeypox.
A Chicago man who recently traveled to Europe has Illinois’ first probable case of monkeypox, state and Chicago health officials said Thursday.
Could these cases be pointing to a new nexus of monkeypox in Europe where the virus is now endemic, having found a reservoir host within European animal populations?
This possibility cannot be excluded, simply because even within Africa, the reservoir host for monkeypox is unknown.
The natural reservoir of monkeypox remains unknown. However, African rodents and non-human primates (like monkeys) may harbor the virus and infect people.
Monkeypox is considered endemic to Africa simply because, until now, cases have either appeared in West and Central Africa or have had travel links to that region. As was noted in the reporting on the Massachusetts case which was the first reported case of monkeypox in the US for 2022, last year two isolated cases of monkeypox were reported in the US, both with travel links to Nigeria.
No monkeypox cases have previously been identified in the United States in 2022; Texas and Maryland each reported a case in 2021 in people with recent travel to Nigeria.
The Massachusetts case, along with many of the other cases reported in the United States recently, have had travel links to Canada, but, so far, no cases in the US with direct travel links to Africa have emerged.
How did the virus get to Canada and Europe?
As the WHO notes, only a few of the cases of monkeypox outside of Africa have had travel links to Africa. This is fueling speculation that monkepox may have been spreading undetected for some time.
The sudden and unexpected appearance of monkeypox simultaneously in several non-endemic countries suggests that there might have been undetected transmission for some unknown duration of time followed by recent amplifier events.
Given that genomic sequencing links several of the current monkeypox cases to the West African clade, and that, as BNO News states on their Monkeypox tracker, the first reported case in London had travel links to Nigeria, there is little doubt that the virus ultimately arrived in Europe from Africa. The question is whether monkeypox has now found a European host animal to act as a natural reservoir from which humans can be infected even without direct travel to West Africa.
Making the question even more compelling is a first draft genome sequence of a monkeypox viral sample isolated from a case in Portugal, which appears to link at least that Portuguese case to a 2018-2019 monkeypox outbreak in Nigeria, which was noteworthy for having the first documented cases of monkeypox being exported outside the known endemic region in Africa.
A first rapid phylogenetic analysis of the draft genome (Figure 1) indicates that the 2022 virus belongs to the West African clade and is most closely related to viruses associated with the exportation of monkeypox virus from Nigeria to several countries in 2018 and 2019, namely the United Kingdom, Israel and Singapore
Is the current outbreak in non-endemic countries related to the 2018-2019 outbreak where cases were exported to the UK and Israel? The possibility not only cannot be ruled out, but early evidence may even support that hypothesis.
Would such a linkage, if substantively proven, raise the likelihood monkeypox is now endemic in Europe? With the current data in hand, that question is for now unanswerable.
The possibility that monkeypox has taken up residence in Europe cannot be affirmatively excluded. It is even possible some of the extant data points towards endemicity within Europe.
Monkeypox Spreading More Aggressively Outside Africa Than Within Africa
The 7-day average of non-endemic monkeypox cases as reported by BNO News indicates the virus has been spreading more aggressively outside of Africa.
While the current outbreak in Africa (and the WHO bulletins show the monkeypox outbreak in Africa is ongoing) has resulted in some 1,408 suspected cases since January, outside of Africa over two thirds that number of cases have been detected in just a few weeks.
If monkeypox is not now endemic in Europe, the alternative is to somehow explain the same virus—and, by implication, the same viral strain—spreading more aggressively outside of Africa while spreading much less aggressively within Africa. If, as the concentration of African monkeypox cases within the Democratic Republic of Congo suggests, the African cases also involve the Congo Basin clade, which so far is not implicated in the non-endemic cases, the disparity in disease spread becomes even greater, as does the challenge of explaining that disparity.
Expanded endemicity would go a long way towards resolving that challenge.
(Note: the bioweapons hypotheses advanced in some circles would also go a long way towards resolving that challenge. For reasons of focus and brevity I am not addressing those possibilities here, and may do so in a separate article)
COVID Inoculation Link?
One disturbing possibility to explain the monkeypox outbreak’s greater aggressiveness outside of Africa must be considered: the COVID-19 inoculations.
One unavoidable statistical reality of the outbreak is that the countries where monkeypox is traditionally considered to be endemic are have fairly low rates of inoculation, and the countries outside of Africa with the most monkeypox cases all have high rates of inoculation.
Nor can we avoid the empirical fact that the non-endemic countries are experiencing greater numbers of cases than every endemic country except the Democratic Republic Of Congo—a country where the native monkeypox clade is the Congo Basin clade, known to be far more deadly than the West African clade associated with the European cases.
Is this proof that the COVID inoculations are involved? No. It could be mere coincidence.
Yet, as Igor Chudov recently documented, Omicron variants BA.4 and BA.5 are proving far greater problems for highly inoculated Portugal than for much less inoculated South Africa.
Moreover, if, as I have speculated previously, Paxlovid rebound occurs with greater frequency among inoculated patients than non-inoculated patients, those cases present a possible reality of immune system damage among inoculated patients.
Additionally, multiple studies such as this Danish cohort study confirm negative efficacy of the inoculations against Omicron: over time the inoculations make people more susceptible to Omicron variants of SARS-CoV-2. Alex Berenson detailed this phenomenon back in January in his Unreported Truths substack.
In this paper, we present evidence that vaccination induces a profound impairment in type I interferon signaling, which has diverse adverse consequences to human health.
While there is no proven link between COVID inoculation and monkeypox infection, there is plainly a growing body of evidence the COVID inoculations produce lasting immune system damage extending beyond susceptibility to SARS-CoV-2 variants.
Against this backdrop of immune system damage arising from the COVID inoculations, might the more aggressive spread of monkeypox in Europe be an expression of a generally weaker immune system?
The data is nowhere close to providing an answer to that question, yet there is enough data to establish the question is hardly an unreasonable one.
Africa Provides Important Context
What is clear from the data is that the current outbreaks of monkeypox in Africa are an essential context to apprehending the non-endemic cases in Europe and North America. Whether the current “non-endemic” outbreak heralds an expansion of the endemic region for monkeypox to include Europe, or whether it highlights widespread immune system compromise due to COVID inoculation, it is the appreciation of the monkeypox cases in Africa that provide the necessary framework for perceiving what is unfolding here.
So far, no one has died from monkeypox outside of Africa. That fact alone precludes the outbreak from being considered a pandemic, and there is no denying that, thus far, monkeypox does not present a major healthcare risk in either Europe or the Americas.
Yet the cases present several mysteries, and raise disturbing questions. Depending on the ultimate answers to those questions, the “non-endemic” monkeypox outbreak may prove to be an immunological “canary in the coal mine”, alerting to far greater virological dangers down the road.
This becomes very apparent the moment we include Africa in our understanding of the monkeypox outbreak.