Monkey pox | “It is the largest outbreak ever seen in Europe”: what is this disease, already detected in 11 countries, and what risks does it pose to health?

A strange virus is spreading.

The appearance of a case of monkeypox in the United Kingdom on May 7 raised alarm bells.

With the passing of days, the disease began to spread and dozens of cases have already been identified in 11 countries with one peculiarity: sexual intercourse seems to play an important role in contagion.

The United Kingdom reported this Friday already two dozen confirmed cases. In Spain, Portugal, Italy, Canada, the United States, Australia, Sweden, France, Belgium and Germany, the disease has also been detected.

The Netherlands reported numerous suspected cases on Friday, although they had not yet been verified by studies.

“With several confirmed cases in the UK, Spain and Portugal, this is the largest and most widespread outbreak of monkeypox ever seen in Europe,” the German armed forces medical service said.

An official of the World Health Organization (WHO) expressed concern on Friday about the spread of monkeypox.

“As we enter the summer season in the European region, with mass gatherings, festivals and parties, I am concerned that transmission may accelerate as the cases being detected are from people having sex, and the symptoms are unknown. for many,” WHO regional director for Europe Hans Kluge said in a statement.

All are young adults and most are men who have sex with men. But not all cases are like this, ”the region’s general director of Public Health, Elena Andradas, told a Spanish radio about the cases in Madrid.

The official added that there were no women among the identified patients and that those infected men who only had sex with women had maintained “high risk sex”.

Although there is no vaccine developed specifically against monkeypox, some countries resort to the humanpox injection, as it offers 85% protection because the two viruses are quite similar.

UK authorities say they have bought smallpox vaccines and started offering them to those with “higher levels of exposure” to monkeypox.

Meanwhile, Spain is evaluating it. “We are assessing the possible usefulness of the smallpox vaccine if it is finally confirmed that we have cases of monkeypox, and the role it could play in controlling the transmission of the infection,” reported Andradas.

What is monkeypox?

Science Photo Library
Monkeypox virus particle.

Monkeypox is caused by the virus of the same name, a member of the smallpox family of viruses.

“Monkeypox is a zoonosis – those diseases that are transmitted from animals to humans – of the jungle type, with incidental human infections, generally occurring sporadically in forested areas of Central and West Africa“, said this Wednesday at a press conference the adviser on Disease Prevention and Control of the Pan American Health Organization (PAHO), the epidemiologist Enrique Pérez.

“It is caused by a virus, the smallpox virus, and it belongs to a family of viruses that are the orthopoxviruses,” he specified.

“It manifests itself with a pustular eruption (pimples filled with pus) and it is a systemic disease that can vary from a mild form (…) to a more serious disease and including death“, he added.

In Africa, case fatality rates are between 4% and 22% and most patients are children.

“What do we recommend? Any illness that occurs during travel or return from an endemic area should be reported to health professionals, including recent travel information and vaccination history.”

“People who reside or travelers who go to endemic countries should always avoid contact with sick animals, which can harbor the smallpox virus,” Pérez said.

What is known about the first infected?

Two of the infected patients in the UK traveled from Nigeria, so they are likely to have the COVID-19 strain of the virus. West Africa, which is generally mild.

The third case was a health worker who contracted the virus from one of the patients.

The following four cases, three in London and one in the northeast of England, have no known links to each other and no travel history.

The UK Health Security Agency said anyone who has concerns they may be infected should see a healthcare professional.

What are the symptoms?

An infected baby and his mother await treatment for monkeypox in the Central African Republic.

Getty Images
The majority of patients with this disease in Africa are children.

Initial symptoms include fever, headaches, swelling, back pain, muscle pain, and general listlessness.

Once the fever passes, a rash can develop, often starting on the face and then spreading to other parts of the body, most commonly the palms of the hands and soles of the feet.

The rash, which can be very itchy, changes and goes through different stages before finally forming a scab, which then falls off. Injuries can cause scarring.

The infection usually goes away on its own and lasts two to four weeks. Most cases are mild, sometimes resembling chickenpox.

How do you get infected?

Monkeypox can be spread when someone is in close contact with an infected person.

PAHO’s Perez said it is transmitted through large exhaled droplets. It can enter the body through broken skin, the respiratory tract, or the eyes, nose, or mouth, and has an incubation period of 6 to 13 days, although it can be as long as 21 days.

Viral excretion through feces can also be a route of transmission of the virus.

Although it is called “monkeypox”, it is also transmitted by rodents, marsupials and other primates. PAHO noted that the population “should avoid handling animals.”

A hand petting a prairie dog

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Rodents are one of the groups of animals that transmit monkeypox.

It can also be spread by contact with infected animals or by objects contaminated with viruses, such as clothing.

How common are breakouts?

The virus was first identified in a captive monkey and since 1970 sporadic outbreaks have been reported in 10 African countries.

In 2003 there was an outbreak in the US, the first time the disease had been seen outside of Africa.

The patients contracted the disease through close contact with rodents that had been infected by small mammals – rats, dormouse and squirrels – imported from Africa.

A total of 81 cases were reported, but none resulted in death.

In 2017, Nigeria experienced the largest documented outbreak, some 40 years after the country had its last confirmed cases of monkeypox. There were 172 suspected cases and 75% of the victims were men between the ages of 21 and 40.

This year Nigeria registered 46 suspected cases, of which 15 are confirmed, according to the WHO.

There is no treatment for monkeypox, but outbreaks can be controlled by preventing infection.

Hand with lesions caused by monkeypox

Getty Images
One of about 20 patients infected with monkeypox in the United States in 2003.

Is there a resurgence of monkeypox?

In Africa yes. From 2016 to date, more cases were detected than in the previous 40 years, according to Raúl Rivas González, professor of Microbiology at the University of Salamanca (Spain), in an article published in The Conversation.

On the reason for this resurgence, Rivas González marks four reasons:

  • the cessation of vaccination against smallpox in 1980, which caused a drop in immunity against orthopoxviruses;
  • the more frequent exposure to animals that are reservoirs of the disease;
  • the increase in the rate of transmission between humans, especially in those immunocompromised people;
  • progress in the ability to diagnose and the development of health education programs.
  • Should I be worry?

    British experts say they are nowhere near a local outbreak and, according to England’s public health office, the risk to the population is low.

    Jonathan Ball, Professor of Molecular Virology at the University of Nottingham, said: “The fact that only one of the 50 contacts of the initial monkeypox-infected patient has been infected shows how poorly infectious the virus is.

    Nick Phin, deputy director of the National Infection Service at the English public health office, added: “It is important to emphasize that monkeypox does not spread easily between people and the risk to the general public is very low.”

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