Vigilance is required now international travel is back, says Associate Professor Sanjaya Senanayake.

Emerging cases of monkeypox, polio, and a new virus in China have many wondering if we are living in unusual times or if the pandemic has made us a little jumpy.

In his recent COVID update for Healthed, infectious diseases expert Associate Professor Sanjaya Senanayake from Canberra Hospital and the Australian National University, described the current spate of outbreaks as extraordinary.

“It is a crazy time for infectious diseases,” said A/Prof Senanayake. “I wouldn’t be surprised if we hear about other emerging infections by the end of the year. They’re most likely to come from the animal world as human and animal habitats impinge more and more on each other.”

Healthed’s next COVID update will be presented by Associate Professor Nigel Crawford on 13 September. Register here.

Globally, there are over 50,000 cases of monkeypox in 99 countries. In Australia, local transmission has been occurring in Victoria, and more recently, New South Wales.

Professor Senanayake said GPs should be aware that the original vaccine for monkeypox is not suited to immunocompromised patients, as it actively replicates in its recipient.

“The JYNNEOS vaccine is safe for everyone but getting our hands on it hasn’t been easy,” he said. “The government is expecting a larger supply to come in the next few months. An antiviral, TPOXX, is also available but supply may be an issue as well.

“If COVID wasn’t here, I’d be shaking my head at monkeypox. On a more optimistic note, the outbreak might be slowly starting to subside, but it’s too early to say.”

Polio has made a comeback in the form of a vaccine-derived strain, which recently appeared in wastewater in the UK and New York. It has raised concerns for unvaccinated parts of the population.

In June, an unvaccinated 20-year-old man in New York became the first person in the US in nearly a decade to be diagnosed with polio.

“If you’re immunised against polio, then you’re fine. But if you’re not immunised, it’s a problem,” said Professor Senanayake.

“Unfortunately, that young man has acute flaccid paralysis. That happens in one in 1,000 to 2,000 cases. My understanding is that he’s from a population where the uptake of the vaccine hasn’t been very good, so there could be a lot of other cases there.”

With international travel back in full swing, Professor Senanayake said making sure everyone’s vaccinations are up to date will help avoid further polio outbreaks.

Another disease to be aware of is a new zoonotic heniparvirus identified in China. In August, the New England Journal of Medicine reported the virus has been found in humans and mouse-like shrews.

Named ‘Langya’, the virus can cause respiratory problems but only 35 people have been infected since 2018 and the virus does not appear to be fatal or transmit easily in its current form.

“Thankfully at this stage it doesn’t look like it’s going to cause the next pandemic. But as we have seen with monkeypox and COVID, the ability to mutate and change is always there, so we have to be vigilant,” Professor Senanayake said.

Another virus that has hit headlines in recent weeks is the ‘tomato flu’ in India. Scientists are still trying to identify what this disease is. It is called ‘tomato flu’ because the virus causes skin rashes that are red and the size of a tomato.

“It looks like the virus is mild and goes away on its own, but most people who have had this infection are young, and we don’t really know what might happen in an immunocompromised person or if it spreads to elderly people,” Professor Vasso Apostolopoulos, an immunology and translational group leader at Victoria University told the NewsGP.

“At the moment it is still isolated and doesn’t appear to have spread beyond India.”

Healthed’s next COVID update will be presented by Associate Professor Nigel Crawford on 13 September. Register here.