Monkeypox: what is this disease detected in Europe and North America and what risks does it pose to health

A stranger virus it is expanding.

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 nine infected have already been identified in that country, with one peculiarity: sexual intercourse seems to play an important role in contagion.

The United States reported this Wednesday a confirmed case; a man who had recently traveled to Canada and was hospitalized, although he was in good condition.

Portugal reported on Tuesday that it detected five cases of men between the ages of 20 and 50 at a clinic for sexually transmitted diseases. The next day the Iberian country identified another nine, totaling 14 patients with monkeypox.

Spain reported this Wednesday the suspicion of eight patients who could be infected, and later raised the number to 23.

“All are young adults and most are men who have sex with men. But not all cases are like this,” declared the general director of Public Health of the Community of Madrid, Elena Andradas, to a radio station of the Spanish Cadena Ser.

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

Andradas said that the infected are isolated and that they are progressing favorably.

“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,” the Madrid official reported.

What is monkeypox?

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 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 while traveling or returning 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.

This Wednesday two more cases were identified.

The UK Health Security Agency said anyone with concerns they might be infected should see a healthcare professional.

What are the symptoms?

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 stated that the population “should refrain from handling animals.”

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 a shipment of 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.

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

Smallpox vaccination has been shown to be 85% effective in preventing monkeypox and is still sometimes used.

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, in an article published in The Conversation.

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

• the cessation of smallpox vaccination 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.”