Monkeypox, three months later: specific symptoms and mortality

Monkeypox, three months later: specific symptoms and mortality

London, May 4, 2022 – A man admitted with a rash and fever is the first confirmed case with symptoms of monkeypox outside of Africa in six months. There have been isolated cases since 2018all imported from countries like Nigeria, where the virus was considered endemic monkey pox. But three months later, we are faced with the largest international outbreak of monkeypox in its entire history.

The first Spanish case of monkeypox the symptoms started on April 26th that is, on dates similar to the onset of symptoms in the British patient who came from Nigeria. The latest report from the Carlos III Health Institute includes 4,298 cases reported in Spain since then.

The epidemic curve suggests this There hasn’t been an exponential explosionl. In other words, it doesn’t compare to the start of the coronavirus pandemic and a good chunk of its waves. The infections are persistent, says medical professor Paul Hunter (UEA) from London. In the countries where the spread started (UK, Spain and Portugal), “the number of new cases reported weekly now seems to be declining. But we still have a long way to go before we can relax risk persists another increase.

“New” symptoms and signs in this monkeypox outbreak

As we have learned from the coronavirus crisis, last week the World Health Organization (WHO) urged anyone with monkeypox-like symptoms to isolate themselves immediately and not to travel. The problem is that the list of symptoms and signs in the early stages is common to other diseases, including Covid. According to the WHO, this graphic shows the classic characteristics of monkeypox symptoms. However, in Spain or the UK, the prevalence of the type and location of the lesions has changed.


In addition to general malaise and fever, there is usually something very characteristic: inflammation of the cervical lymph nodes. Having “swollen glands” is a more typical symptom of monkeypox than the eradicated smallpox. Then a rash develops (first in wheals, then in pustules), which can sometimes be confused with chickenpox.

However, this outbreak seems to have very characteristic clinical manifestations. Thus, according to the ISCIII-SIVIES report, lesions are limited to the Genital and anal area (60.3%), when lesions were typically observed primarily on the face, hands, and feet. These specific signs and symptoms of monkeypox prompted WHO Director-General Tedros Adhanom to call for refraining from risky sexual practices and limiting the number of partners for intimate encounters.

Physicians Anne Rimoin and Raina MacIntyre support a hypothesis: the high incidence results from accidental introduction into Europe during one or more superspreading events. Sex is secondary, the key was (and would be) close contact.

It is not a sexually transmitted disease, but sex is involved in 82% of cases

dr Teadros specifically mentioned the group of men who have sex with men (95% of the time), which was disliked by LGTBI associations, which denounce the stigma inflicted on a group that is not the only one affected.

He also insisted that pregnant women, children and those with weakened immune systems should be given special protection because “everyone who is exposed can become infected”. In Spain, according to the report, the 16.7% of the cases cannot be linked to sexual intercourse between men. 82.1% of infections of known origin involved a sexual encounter, with men or women.

This leads to the question whether we now call monkeypox a venereal disease (sexually transmitted diseases). The outbreaks produced up to 2022 did not suggest this at all. The typical infection occurred through contact with animals that carried the virus. Its natural reservoirs are some rodents from the African forests. Their bites or scratches or their poorly cooked consumption have led to human infections.

Human-to-human transmission was possible until 2022, but not as frequently. Typically through skin-to-skin contact or through small droplets of saliva. Also, touching towels, clothing, or sheets that are highly exposed to an infected person’s rash. But it was found viruses in semen, although it is not known if it is infectious in this condition.

This is indicated by the genetic sequencing of the variant, which is circulating in around seventy countries no more rodent virus, but that it adapts to the human being, which would be a favorable new host. Perhaps hence its contagiousness (R0 = 1.6 to 1.8 or more) and new symptoms or signs specific to monkeypox in 2022.

Why two people died of monkeypox in Spain

The disease, viewed traditionally not seriouslyis linked to the death of two people In our country. Two young men from Valencia and Córdoba ending in a encephalitis. An inflammatory response of brain tissue, such as occurs with other uncontrolled infections.

According to the same report, the 2.8% of cases required hospitalization. In most cases to treat the rash, which is associated with pain and the risk of skin infection. According to the WHO, these untreated infections in the pustules are often the cause of death in those infected in countries where it is endemic in Central or West Africa.

The UK has updated its recommendations and list of signs and symptoms to encourage quarantine of contacts but also clinical management of cases that could end up in hospital.

“Monkeypox symptoms occurred [por hombres con sexo con hombres] you can be different symptoms seen in other outbreakssays Jonathan Ball, Professor of Molecular Virology at the University of Nottingham UK SMC. “Broadening the list of possible symptoms to reflect this will therefore ensure that as many cases as possible can be identified and isolated and their contacts traced,” he explains.

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