#16,941
As I've mentioned often in the past, the name `monkeypox’ is more than a little misleading.
While the virus was first detected (in 1958) in laboratory monkeys, further research has revealed its primary host likely to be rodents or possibly squirrels. Humans can contract it in the wild from an animal bite or direct contact with the infected animal’s blood, body fluids, or lesions.
But this orthopoxvirus (family Poxviridae) can also be transmitted from human-to-human, and potentially from humans-to-other-species, as well as by fomites. Monkeys rarely come into the equation.
But for the past 65 years, the name has stuck, both in the vernacular, and in scientific literature. As have the names of the two major clades (West Africa and Congo Basin), named after the regions where they were first identified.
In June a group of international scientists called for renaming the virus (and its clades) in a position paper called Urgent need for a non-discriminatory and non-stigmatizing nomenclature for monkeypox virus.
While the WHO released a Best Practices for the Naming of New Human Infectious Diseases position paper in 2015, there are literally thousands of existing viruses and/or diseases with problematic names (think: Ebola, Rift Valley Fever, Nipah, West Nile Virus, MERS-CoV, etc.).
The actually naming (or renaming) of viruses is up to the International Committee on Taxonomy of Viruses, but the naming of the disease it causes (think COVID-19) is within the purview of the World Health Organization.
Renaming a virus isn't as easy as it might sound. First, you need a consensus from an international committee, and even once that can be agreed upon, there are going to be negative impacts.
To start, the continuity of scientific and medical literature (going back decades) would disrupted. While researchers today might be mindful enough to conduct two searches (new name & old name), over time some of this data could be `lost', or misplaced, or simply ignored.
Add in the revamping of medical and insurance billing codes (on an international scale), the awkwardness for the public (and the press) when a new name is adopted ("X: the virus formerly known as . . . "), and any changes are going to take time to take effect.
None of this is to say it can't be done, and overnight the WHO announced that a small step has been taken, and the WHO has announced new designations for the (formerly West African and Congo Basin) clades of the Monkeypox virus.
Monkeypox: experts give virus variants new names
12 August 2022
News release
Geneva
A group of global experts convened by WHO has agreed on new names for monkeypox virus variants, as part of ongoing efforts to align the names of the monkeypox disease, virus and variants—or clades—with current best practices. The experts agreed to name the clades using Roman numerals.
The monkeypox virus was named upon first discovery in 1958, before current best practices in naming diseases and viruses were adopted. Similarly for the name of the disease it causes. Major variants were identified by the geographic regions where they were known to circulate.
Current best practise is that newly-identified viruses, related disease, and virus variants should be given names with the aim to avoid causing offense to any cultural, social, national, regional, professional, or ethnic groups, and minimize any negative impact on trade, travel, tourism or animal welfare.
Disease: Assigning new names to existing diseases is the responsibility of WHO under the International Classification of Diseases and the WHO Family of International Health Related Classifications (WHO-FIC). WHO is holding an open consultation for a new disease name for monkeypox. Anyone wishing to propose new names can do so here (see ICD-11, Add proposals).
Virus: The naming of virus species is the responsibility of the International Committee on the Taxonomy of Viruses (ICTV), which has a process underway for the name of the monkeypox virus.
Variants/clades: The naming of variants for existing pathogens is normally the result of debate amongst scientists. In order to expedite agreement in the context of the current outbreak, WHO convened an ad hoc meeting on 8 August to enable virologists and public health experts to reach consensus on new terminology.
Experts in pox virology, evolutionary biology and representatives of research institutes from across the globe reviewed the phylogeny and nomenclature of known and new monkeypox virus variants or clades. They discussed the characteristics and evolution of monkeypox virus variants, their apparent phylogenetic and clinical differences, and potential consequences for public health and future virological and evolutionary research.
The group reached consensus on new nomenclature for the virus clades that is in line with best practices. They agreed on how the virus clades should be recorded and classified on genome sequence repository sites.
Consensus was reached to now refer to the former Congo Basin (Central African) clade as Clade one (I) and the former West African clade as Clade two (II). Additionally, it was agreed that the Clade II consists of two subclades.
The proper naming structure will be represented by a Roman numeral for the clade and a lower-case alphanumeric character for the subclades. Thus, the new naming convention comprises Clade I, Clade IIa and Clade IIb, with the latter referring primarily to the group of variants largely circulating in the 2022 global outbreak. The naming of lineages will be as proposed by scientists as the outbreak evolves. Experts will be reconvened as needed.
The new names for the clades should go into effect immediately while work continues on the disease and virus names.
