Cases of monkeypox have doubled in Extremadura in the last ten days

Cases of monkeypox have doubled in Extremadura in the last ten days


Rashes caused by monkeypox. / TODAY

Region administers the first monkeypox vaccine to a contact of an infected person

Tanya Agundez

Monkeypox cases continue to rise in Extremadura. Twenty people have been infected in the region since the first case was reported in June, José María Vergeles, the second vice president and minister of health and social services, reported this Friday. In this way, the region has doubled the number of infected people in just ten days since the number of infected people was 10 on Tuesday, July 19, according to Vergeles himself.

These twenty cases were discovered in just over a month since Extremadura registered its first case of monkeypox on June 10th. This corresponds to a cumulative incidence per million population of 18.88. In response to media inquiries, the Minister of Health has stated that the region is not among the municipalities with the “highest” incidence.

On the other hand, this Thursday the first approved vaccine was administered in Extremadura “according to the criteria for the indication of the vaccine”, Vergeles specified. The 61-year-old vaccinated person is a close contact of a confirmed case.

Vergeles has stressed that the only vaccine approved by the European Medicines Agency (EMA) that is not without risk is given to close contacts when the positive effects outweigh the risks.

In this sense, he explained that since smallpox is a disease almost absent in most countries, the pharmaceutical industry does not produce large quantities of vaccines as they could for other more common diseases, so availability in Europe is very is limited. For this reason, the indications for the puncture are very specific, for example that it should be administered in the first four days after contact with an infected person and only in the case of “proven close contacts”.

Extremadura has a stock of 27 vaccines, with another 27 to be added next week.

mild symptoms

As the consultant himself explained, all people affected by this disease in the region had or have mild symptoms. In addition, it has once again focused on preventing contagion, taking into account that the mechanism of infection of the cases detected so far in the region has been close contact between people and the exchange of fluids.

100% of the identified cases are men. Their ages range from 20 to 63 with an average age of 35.30.

Three cases (15%) have a personal history of positive HIV, the rest (85%) do not.

Vergeles has stated that the most common symptoms of people with monkeypox in the area are skin lesions and general malaise. Most of those infected have a very small network of contacts, as each case does not exceed “at most” four contacts, according to national statistics.

The Minister of Health has also clarified that for this disease there are only two medicines indicated by the EMA: on the one hand, an antiviral, and on the other hand, the vaccine. In this regard, he recalled that all close contacts who are vaccinated based on their age and calendar should not be vaccinated as it is assumed that they are covered.

In fact, 90% of the cases registered in Extremadura are not vaccinated against smallpox, since they belong to an age group in which the administration of this vaccine had already disappeared. The other 2 cases (10%) do not know if they have been vaccinated.

Public Health Emergency

The World Health Organization (WHO) said last Saturday that monkeypox is a public health emergency of “concerning nature” at the international level, the highest level of alert the organization can establish for a disease. So far, only Covid-19 had achieved this risk designation.

This step implies that the WHO recommendations are theoretically binding for the countries that make up the organization. In addition, it means that each of the outbreaks that occur mean that they have to be more strict in their approach, although they have been before.

It should be remembered that Spain is the country in the world with the most detected cases of monkeypox, 3,738, according to the latest report from the Ministry of Health published last Tuesday. This document stated that Extremadura had 17 cases, so three new patients were confirmed in the last few days.

A total of 9,091 confirmed cases of monkeypox had been reported in the rest of Europe as of July 26, including Germany (2,352), the United Kingdom (2,208), France (1,567), the Netherlands (818) and Portugal (588), along with Spain the highest affected countries. Most are young men with a history of relationships in a risky sexual context.

A total of 5,554 confirmed cases were reported in non-endemic countries in the rest of the world, including the United States (3,487), Canada (681), Brazil (813), Peru (208) and Israel (115). the most affected countries.

How the infection occurs

According to the World Health Organization (WHO), infection occurs through direct contact with blood, body fluids, or lesions on the skin or mucous membrane of infected animals. Secondary transmission — person-to-person — can occur through close contact with infected respiratory secretions such as saliva and droplets that we emit when we speak or cough; through contact with the blisters of an infected person; with objects recently contaminated with liquids and skin lesions of the patient; and by the debris and scabs shed from these eruptions. Contact with an affected person’s feces and sexual intercourse are another source of exposure.

Initial symptoms of this disease are fever, headache, muscle aches, back pain, swollen lymph nodes, chills and exhaustion. A rash may develop, usually starting on the face and then spreading to other parts of the body.

The Ministry of Health agreed a protocol with the municipalities on the steps to be followed when a case is identified, as well as the control and surveillance measures. The document proposes isolation and a surgical mask as the main recommendations, along with tracing close contacts.

Cases outside of areas where the disease is endemic

Monkeypox (MPX) is a viral zoonosis whose first human cases were identified in 1970 in the Democratic Republic of the Congo. Endemic to some West and Central African countries, all cases identified outside of these areas up to 2022 were imported or linked to an import case or to animals imported from endemic areas.

However, in May this year, the UK reported the identification of multiple cases without prior travel to endemic areas or contact with previously reported cases. Since then, numerous countries, mainly in Europe and America, have reported confirmed cases or investigational cases with no epidemiological links to endemic areas in West or Central Africa, marking the first time that transmission chains of monkeypox have been reported in Europe and other non-European endemic areas.

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