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Monkey pox: after London, cases in Spain and Portugal

After Great Britain, Portugal and Spain have in turn detected cases of monkeypox: twenty suspected cases in Portugal and 8 suspected cases in Spain. The World Health Organization (WHO) intends to shed light on the spread of this disease in Europe.

The event is rare in Europe and intrigues the health authorities. After a first three cases of monkeypox detected in London in people who had traveled to Nigeria, four new suspected cases were detected in Great Britain, as well as around twenty cases in Portugal and 8 cases in Spain, in people who had not yet traveled to Africa. theThe Spanish and Portuguese authorities have therefore triggered a national health alert.

“In general, monkeypox is transmitted by respiratory transmission, but the characteristics of suspected cases indicate contact with fluids,” said Spanish health authorities. Confirmed cases of monkeypox are overwhelmingly from transmission between men who have sex with men” explains Ibrahima Socé Fall, Deputy Director General ofWHO.

Monkey pox: what symptoms?

Monkeypox was discovered in the 1970s, after human smallpox had been eradicated by vaccine. At this time, there was a resurgence of cases in the Democratic Republic of Congo, recalls the Pasteur Institute. The researchers thus “found that the new cases were cases of monkeypox, caused by small outbreaks of local transmission that did not reach the entire population.” This pathology is also called “simian orthopox virus” or “monkey pox”a zoonosis caused by the simian orthopoxvirus.

The World Health Organization notes for its part that: “The clinical presentation is similar to that observed in patients with formerly smallpox, but less severe.” The incubation period varies from 6 to 16 days (with a maximum of 21 days).

There are generally two periods: a first so-called “invasive” characterized by fever, severe headaches, swollen glands, back and muscle pain, lack of energy. Then comes a skin rash (usually it starts with the face, then the rest of the body is affected). “The rash evolves in about ten days from maculo-papules (flattened base lesions) to vesicles (small fluid-filled blisters), then pustules and finally crusts. The complete disappearance of the latter can take up to three weeks,” says the WHO.

Monkey pox: how is it treated? What risks?

The case fatality rate in monkeypox outbreaks is 1-10%but with appropriate care, most patients recover”, recalls the WHO. There is no specific treatment, nor any particular vaccine. That said, vaccination against human smallpox is also effective against the transmitted form by monkeys, around 85%.

In general, this form of smallpox is cured spontaneously, between 14 and 21 days.. But in children, some severe cases have been recorded. In the event of symptoms or exposure, it is therefore important to contact a doctor in order to be able to be monitored if the patient’s condition worsens.

A low epidemic threshold

The Pasteur Institute specifies that the risk of international spread is limited. Studies have shown that human-to-human transmission was low, the average number of cases caused by an infected subject (called R0) would be less than 1. The WHO states: “Secondary transmission, i.e. human-to-human, can result from close contact with infected respiratory tract secretionsskin lesions of an infected subject or objects recently contaminated with biological fluids or materials from the lesions of a patient.

This is not the first time the virus has been reported outside of Central and West Africa. In 2003, cases had been discovered in the United States. “Most of the patients had been in contact with domestic prairie dogs, infected with imported African rodents,” the WHO points out.

Sources:

  • Monkeypox, WHO.
  • Monkeypox: the epidemic potential increases as long as herd immunity decreases against the viruses responsible for human smallpox, Institut Pasteur, September 2020.
  • Rare case of monkeypox reported in England, UKHSA says, CNN, May 8, 2022.

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